Cerebral physiologic insult burden in acute traumatic neural injury: a Canadian High Resolution-TBI (CAHR-TBI) descriptive analysis

Simple item page
dc.contributor.authorStein, Kevin Y.
dc.contributor.authorGomez, Alwyn
dc.contributor.authorGriesdale, Donald
dc.contributor.authorSekhon, Mypinder
dc.contributor.authorBernard, Francis
dc.contributor.authorGallagher, Clare
dc.contributor.authorThelin, Eric P.
dc.contributor.authorRaj, Rahul
dc.contributor.authorAries, Marcel
dc.contributor.authorFroese, Logan
dc.contributor.authorKramer, Andreas
dc.contributor.authorZeiler, Frederick A.
dc.date.accessioned2024-09-08T00:05:28Z
dc.date.available2024-09-08T00:05:28Z
dc.date.issued2024-09-04
dc.date.updated2024-09-08T00:05:28Z
dc.description.abstractAbstract Background Over the recent decades, continuous multi-modal monitoring of cerebral physiology has gained increasing interest for its potential to help minimize secondary brain injury following moderate-to-severe acute traumatic neural injury (also termed traumatic brain injury; TBI). Despite this heightened interest, there has yet to be a comprehensive evaluation of the effects of derangements in multimodal cerebral physiology on global cerebral physiologic insult burden. In this study, we offer a multi-center descriptive analysis of the associations between deranged cerebral physiology and cerebral physiologic insult burden. Methods Using data from the Canadian High-Resolution TBI (CAHR-TBI) Research Collaborative, a total of 369 complete patient datasets were acquired for the purposes of this study. For various cerebral physiologic metrics, patients were trichotomized into low, intermediate, and high cohorts based on mean values. Jonckheere–Terpstra testing was then used to assess for directional relationships between these cerebral physiologic metrics and various measures of cerebral physiologic insult burden. Contour plots were then created to illustrate the impact of preserved vs impaired cerebrovascular reactivity on these relationships. Results It was found that elevated intracranial pressure (ICP) was associated with more time spent with cerebral perfusion pressure (CPP) < 60 mmHg and more time with impaired cerebrovascular reactivity. Low CPP was associated with more time spent with ICP > 20 or 22 mmHg and more time spent with impaired cerebrovascular reactivity. Elevated cerebrovascular reactivity indices were associated with more time spent with CPP < 60 mmHg as well as ICP > 20 or 22 mmHg. Low brain tissue oxygenation (PbtO2) only demonstrated a significant association with more time spent with CPP < 60 mmHg. Low regional oxygen saturation (rSO2) failed to produce a statistically significant association with any particular measure of cerebral physiologic insult burden. Conclusions Mean ICP, CPP and, cerebrovascular reactivity values demonstrate statistically significant associations with global cerebral physiologic insult burden; however, it is uncertain whether measures of oxygen delivery provide any significant insight into such insult burden.
dc.identifier.citationCritical Care. 2024 Sep 04;28(1):294
dc.identifier.urihttps://doi.org/10.1186/s13054-024-05083-y
dc.identifier.urihttps://hdl.handle.net/1880/119652
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleCerebral physiologic insult burden in acute traumatic neural injury: a Canadian High Resolution-TBI (CAHR-TBI) descriptive analysis
dc.typeJournal Article
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
13054_2024_Article_5083.pdf
Size:
1.33 MB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Open Access Publications