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Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure

A reliable method for non-invasive detection of dangerous intracranial pressure (ICP) elevations is still unavailable. In this preliminary study, we investigate quantitatively our observation that superimposing waveforms of transcranial Doppler blood flow velocity (FV) and arterial blood pressure (A...

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Autores principales: Sawicki, Karol, Placek, Michał M., Łysoń, Tomasz, Mariak, Zenon, Chrzanowski, Robert, Czosnyka, Marek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391497/
https://www.ncbi.nlm.nih.gov/pubmed/34439619
http://dx.doi.org/10.3390/brainsci11081000
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author Sawicki, Karol
Placek, Michał M.
Łysoń, Tomasz
Mariak, Zenon
Chrzanowski, Robert
Czosnyka, Marek
author_facet Sawicki, Karol
Placek, Michał M.
Łysoń, Tomasz
Mariak, Zenon
Chrzanowski, Robert
Czosnyka, Marek
author_sort Sawicki, Karol
collection PubMed
description A reliable method for non-invasive detection of dangerous intracranial pressure (ICP) elevations is still unavailable. In this preliminary study, we investigate quantitatively our observation that superimposing waveforms of transcranial Doppler blood flow velocity (FV) and arterial blood pressure (ABP) may help in non-invasive identification of ICP plateau waves. Recordings of FV, ABP and ICP in 160 patients with severe head injury (treated in the Neurocritical Care Unit at Addenbrookes Hospital, Cambridge, UK) were reviewed retrospectively. From that cohort, we identified 18 plateau waves registered in eight patients. A “measure of dissimilarity” (Dissimilarity/Difference Index, DI) between ABP and FV waveforms was calculated in three following steps: 1. fragmentation of ABP and FV signal according to cardiac cycle; 2. obtaining the normalised representative ABP and FV cycles; and finally; 3. assessing their difference, represented by the area between both curves. DI appeared to discriminate ICP plateau waves from baseline episodes slightly better than conventional pulsatility index did: area under ROC curve 0.92 vs. 0.90, sensitivity 0.81 vs. 0.69, accuracy 0.88 vs. 0.84, respectively. The concept of DI, if further tested and improved, might be used for non-invasive detection of ICP plateau waves.
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spelling pubmed-83914972021-08-28 Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure Sawicki, Karol Placek, Michał M. Łysoń, Tomasz Mariak, Zenon Chrzanowski, Robert Czosnyka, Marek Brain Sci Article A reliable method for non-invasive detection of dangerous intracranial pressure (ICP) elevations is still unavailable. In this preliminary study, we investigate quantitatively our observation that superimposing waveforms of transcranial Doppler blood flow velocity (FV) and arterial blood pressure (ABP) may help in non-invasive identification of ICP plateau waves. Recordings of FV, ABP and ICP in 160 patients with severe head injury (treated in the Neurocritical Care Unit at Addenbrookes Hospital, Cambridge, UK) were reviewed retrospectively. From that cohort, we identified 18 plateau waves registered in eight patients. A “measure of dissimilarity” (Dissimilarity/Difference Index, DI) between ABP and FV waveforms was calculated in three following steps: 1. fragmentation of ABP and FV signal according to cardiac cycle; 2. obtaining the normalised representative ABP and FV cycles; and finally; 3. assessing their difference, represented by the area between both curves. DI appeared to discriminate ICP plateau waves from baseline episodes slightly better than conventional pulsatility index did: area under ROC curve 0.92 vs. 0.90, sensitivity 0.81 vs. 0.69, accuracy 0.88 vs. 0.84, respectively. The concept of DI, if further tested and improved, might be used for non-invasive detection of ICP plateau waves. MDPI 2021-07-29 /pmc/articles/PMC8391497/ /pubmed/34439619 http://dx.doi.org/10.3390/brainsci11081000 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sawicki, Karol
Placek, Michał M.
Łysoń, Tomasz
Mariak, Zenon
Chrzanowski, Robert
Czosnyka, Marek
Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure
title Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure
title_full Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure
title_fullStr Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure
title_full_unstemmed Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure
title_short Change in Blood Flow Velocity Pulse Waveform during Plateau Waves of Intracranial Pressure
title_sort change in blood flow velocity pulse waveform during plateau waves of intracranial pressure
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391497/
https://www.ncbi.nlm.nih.gov/pubmed/34439619
http://dx.doi.org/10.3390/brainsci11081000
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