2.50
Hdl Handle:
http://hdl.handle.net/10755/158051
Type:
Presentation
Title:
Intracranial Pressure Waveform Analysis in Traumatic Brain Injury
Abstract:
Intracranial Pressure Waveform Analysis in Traumatic Brain Injury
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:Fan, Jun-Yu, PhD, RN
P.I. Institution Name:Chang Gung Institute of Technology
Title:Director
Contact Address:261 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan, 00333, ROC
Contact Telephone:886-3-211899 Ext 5888
Intracranial hypertension from primary and secondary injuries is one of the most prominent concerns while taking care of individuals with severe traumatic brain injury (TBI). Intracranial pressure (ICP) increases depend upon compensatory processes within the craniospinal space, also referred to as intracranial adaptive capacity. ICP dynamics in TBI individuals with "decreased intracranial adaptive capacity" is manifested by disproportionate increase in intracranial pressure (DIICP) in response to a variety of stimuli. However, no well-validated measures are available in clinical practice to predict the development of a DIICP. The purpose of this study is to investigate if there are trends of ICP dynamics on a minute-by-minute basis and unique patterns of ICP pulse waveform morphology on a beat-by-beat basis within a time period of 30 minute prior to the development of a DIICP event. A total of 38 individuals with severe TBI were sampled from a randomized controlled trial regarding cerebral perfusion pressure management in individuals with TBI or subarachnoid hemorrhage. The investigator retrospectively examined the trends of changes in mean ICP on a one-minute basis for 30 consecutive minutes prior to the DIICP event. An automatic detection program was developed to identify the components, namely P1 and P2, of the ICP pulse waveform. The results showed that there was a significantly increasing trend in mean ICP prior to the development of DIICP, compared with the comparison data set (p<0.05). In terms of the ICP pulse waveform analysis, a P2 elevation, defined as P2/P1 ratio greater than 0.8, was found prior to the DIICP event, but it also appeared in the comparison data set. Accordingly, this ratio is not a reliable clinical indicator to predict a DIICP event. The current results demonstrate that a qualitative increase in mean ICP, but not P2 elevation, has the potential to serve as a DIICP predictor. In particular, it may be feasible to display the ICP trend in a clinical bedside monitoring system to elucidate the relationship between the ICP dynamics and DIICP. Future studies are warranted to search for composite indicators of DIICP that incorporate other physical parameters and their predictive capacity for neurologic outcome.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleIntracranial Pressure Waveform Analysis in Traumatic Brain Injuryen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158051-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Intracranial Pressure Waveform Analysis in Traumatic Brain Injury</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Fan, Jun-Yu, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Chang Gung Institute of Technology</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Director</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">261 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan, 00333, ROC</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">886-3-211899 Ext 5888</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jyfan@gw.cgit.edu.tw</td></tr><tr><td colspan="2" class="item-abstract">Intracranial hypertension from primary and secondary injuries is one of the most prominent concerns while taking care of individuals with severe traumatic brain injury (TBI). Intracranial pressure (ICP) increases depend upon compensatory processes within the craniospinal space, also referred to as intracranial adaptive capacity. ICP dynamics in TBI individuals with &quot;decreased intracranial adaptive capacity&quot; is manifested by disproportionate increase in intracranial pressure (DIICP) in response to a variety of stimuli. However, no well-validated measures are available in clinical practice to predict the development of a DIICP. The purpose of this study is to investigate if there are trends of ICP dynamics on a minute-by-minute basis and unique patterns of ICP pulse waveform morphology on a beat-by-beat basis within a time period of 30 minute prior to the development of a DIICP event. A total of 38 individuals with severe TBI were sampled from a randomized controlled trial regarding cerebral perfusion pressure management in individuals with TBI or subarachnoid hemorrhage. The investigator retrospectively examined the trends of changes in mean ICP on a one-minute basis for 30 consecutive minutes prior to the DIICP event. An automatic detection program was developed to identify the components, namely P1 and P2, of the ICP pulse waveform. The results showed that there was a significantly increasing trend in mean ICP prior to the development of DIICP, compared with the comparison data set (p&lt;0.05). In terms of the ICP pulse waveform analysis, a P2 elevation, defined as P2/P1 ratio greater than 0.8, was found prior to the DIICP event, but it also appeared in the comparison data set. Accordingly, this ratio is not a reliable clinical indicator to predict a DIICP event. The current results demonstrate that a qualitative increase in mean ICP, but not P2 elevation, has the potential to serve as a DIICP predictor. In particular, it may be feasible to display the ICP trend in a clinical bedside monitoring system to elucidate the relationship between the ICP dynamics and DIICP. Future studies are warranted to search for composite indicators of DIICP that incorporate other physical parameters and their predictive capacity for neurologic outcome.</td></tr></table>en_GB
dc.date.available2011-10-26T20:27:38Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:27:38Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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