An optimal frequency range for assessing the pressure reactivity index in patients with traumatic brain injury
Artikel i vetenskaplig tidskrift, 2015

The objective of this study was to identify the optimal frequency range for computing the pressure reactivity index (PRx). PRx is a clinical method for assessing cerebral pressure autoregulation based on the correlation of spontaneous variations of arterial blood pressure (ABP) and intracranial pressure (ICP). Our hypothesis was that optimizing the methodology for computing PRx in this way could produce a more stable, reliable and clinically useful index of autoregulation status. The patients studied were a series of 131 traumatic brain injury patients. Pressure reactivity indices were computed in various frequency bands during the first 4 days following injury using bandpass filtering of the input ABP and ICP signals. Patient outcome was assessed using the extended Glasgow Outcome Scale (GOSe). The optimization criterion was the strength of the correlation with GOSe of the mean index value over the first 4 days following injury. Stability of the indices was measured as the mean absolute deviation of the minute by minute index value from 30-min moving averages. The optimal index frequency range for prediction of outcome was identified as 0.018-0.067 Hz (oscillations with periods from 55 to 15 s). The index based on this frequency range correlated with GOSe with ρ = -0.46 compared to -0.41 for standard PRx, and reduced the 30-min variation by 23 %. © 2014 Springer Science+Business Media New York.

Cerebral perfusion pressure

Cerebral pressure autoregulation

Optimization

Clinical monitoring

Intracranial pressure

Författare

T.P. Howells

Uppsala universitet

U. Johnson

Uppsala universitet

Tomas McKelvey

Chalmers, Signaler och system, Signalbehandling och medicinsk teknik

P. Enblad

Uppsala universitet

Journal of Clinical Monitoring and Computing

1387-1307 (ISSN) 1573-2614 (eISSN)

Vol. 29 1 97-105

Styrkeområden

Informations- och kommunikationsteknik

Livsvetenskaper och teknik (2010-2018)

Ämneskategorier

Signalbehandling

DOI

10.1007/s10877-014-9573-7

Mer information

Senast uppdaterat

2021-10-05