Next Article in Journal
Evaluation of hydration status calculated from differences in venous and capillary plasma dilution during stepwise crystalloid infusions: A randomized crossover study in healthy volunteers
Previous Article in Journal
Mortality prediction in patients with acute kidney injury requiring renal replacement therapy after cardiac surgery
Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Association between the outcome of traumatic brain injury patients and cerebrovascular autoregulation, cerebral perfusion pressure, age, and injury grades

1
Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania
2
Centre of Neuroangiosurgery, Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2016, 52(1), 46-53; https://doi.org/10.1016/j.medici.2016.01.004
Received: 9 October 2014 / Accepted: 15 January 2016 / Published: 28 January 2016
Background and objective: The aim of this study was to explore the association of cerebrovascular autoregulation (CA) and optimal cerebral perfusion pressure (CPP) managing conditions with the outcome of traumatic brain injury (TBI) patients including additional information about the patients' age and grade of diffuse axonal injury (DAI).
Materials and methods: The CA monitoring of 28 TBI patients was performed by using ICM+ software (Cambridge, UK). The CA status estimating pressure reactivity indexes (PRx) and CPP data were processed in order to obtain information on the patient-specific treatment conditions by calculating the optimal CPP.
Results: There was a negative correlation between the Glasgow outcome scale (GOS) score and PRx (r = -0.448 at hospital discharge and r = -0.402 after 6 months). The estimated threshold value PRx of >0.24 was associated with mortality. The correlation coefficients between the GOS score and the difference CPP-optimal CPP were 0.549 at hospital discharge and 0.484 after 6 months. The threshold value of CPP declination from DCPPopt per -6 mmHg was associated with mortality. Poorer outcome was predicted for elderly TBI patients (aged >47 years) and patients having a DAI grade of 3.
Conclusions: The association of the GOS score with CPP, CA impairment conditions, age and diffuse axonal injury (DAI) grade showed that the outcomes of TBI patients were associated with patient-specific CPP management and better outcomes were obtained for younger patients, for patients having lower DAI grade and for patients whose CPP was kept within the range from the optimal CPP to the optimal CPP + 10 mmHg.
Keywords: Outcome; Traumatic brain injury; Cerebrovascular autoregulation monitoring; Optimal cerebral perfusion pressure Outcome; Traumatic brain injury; Cerebrovascular autoregulation monitoring; Optimal cerebral perfusion pressure
MDPI and ACS Style

Petkus, V.; Krakauskaitė, S.; Preikšaitis, A.; Ročka, S.; Chomskis, R.; Ragauskas, A. Association between the outcome of traumatic brain injury patients and cerebrovascular autoregulation, cerebral perfusion pressure, age, and injury grades. Medicina 2016, 52, 46-53.

Show more citation formats Show less citations formats

Article Access Map by Country/Region

1
Back to TopTop