Nina Sundström
A5089744368- Traumatic Brain Injury and Neurovascular Disturbances
- Traumatic Brain Injury Research
- Trauma and Emergency Care Studies
- Cerebrospinal fluid and hydrocephalus
- Cardiac Arrest and Resuscitation
- Neurosurgical Procedures and Complications
- Sepsis Diagnosis and Treatment
- Spinal Dysraphism and Malformations
- Optical Imaging and Spectroscopy Techniques
- S100 Proteins and Annexins
- Fetal and Pediatric Neurological Disorders
- Radiation Dose and Imaging
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Spinal Fractures and Fixation Techniques
- Acute Ischemic Stroke Management
- Asthma and respiratory diseases
- Balance, Gait, and Falls Prevention
- Autopsy Techniques and Outcomes
- Cardiovascular and Diving-Related Complications
- Machine Learning in Healthcare
- Cardiovascular Health and Disease Prevention
- Social and Educational Sciences
- Thermal Regulation in Medicine
- Respiratory Support and Mechanisms
- Heart Rate Variability and Autonomic Control
Umeå University
2016-2025
Charité - Universitätsmedizin Berlin
2020-2022
Humboldt-Universität zu Berlin
2020-2022
University of Groningen
2022
University of Milano-Bicocca
2022
University of Turku
2022
University Medical Center Hamburg-Eppendorf
2022
University of Manitoba
2022
Turku University Hospital
2022
Assistance Publique – Hôpitaux de Paris
2022
CPPopt denotes a Cerebral Perfusion Pressure (CPP) value at which the Pressure-Reactivity index, reflecting global state of Autoregulation, is best preserved. has been investigated as potential dynamically individualised CPP target in traumatic brain injury patients admitted intensive care unit. The prospective bedside use concept requires ensured safety and reliability recommended targets based on automatically-generated CPPopt. We aimed to: Increase stability automated algorithm by...
A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below individual lower limit reactivity (LLR) is associated mortality in traumatic brain injury (TBI) patients. We aim to validate this a large multicentre cohort.Recordings from 171 TBI patients high-resolution cohort CENTER-TBI were processed ICM+ software. derived LLR as trend CPP at level for which index (PRx) indicates impaired cerebrovascular low CPP. The...
The physiological effect of posture on intracranial pressure (ICP) is not well described. This study defined and evaluated three mathematical models describing the postural effects ICP, designed to predict ICP at different head-up tilt angles from supine value. Model I was based a hydrostatic indifference point for cerebrospinal fluid (CSF) system, i.e., existence in system where independent body position. Models II III were Davson's equation CSF absorption, which relates venous pressure,...
Cerebral autoregulation, as measured using the pressure reactivity index (PRx), has been related to global patient outcome in adult patients with traumatic brain injury (TBI). To date, this documented without accounting for standard baseline admission characteristics and intracranial (ICP). We evaluated association, adjusting ICP, a multi-center, prospective cohort. derived PRx correlation between ICP mean arterial prospectively collected multi-center data from High-Resolution Intensive Care...
It has been postulated previously that individualized cerebral perfusion pressure (CPP) targets can be derived from cerebrovascular reactivity indices. Differences between real CPP and target (named generically optimal CPP) linked to global outcome in adult traumatic brain injury (TBI). Different vascular indices utilized the determination. The goal of this study is evaluate CPPopt parameters, three intracranial (ICP)–derived indices, determine which one superior for 6- 12-month prediction....
Recent interest in intracranial pressure (ICP) the upright posture has revealed that mechanisms regulating postural changes ICP are not fully understood. We have suggested an explanatory model where depend on well-established hydrostatic effects venous system and these interrupted by collapse of internal jugular veins (IJVs) more positions. The aim this study was to investigate relationship simultaneous invasive measurements ICP, pressure, IJV healthy volunteers. (monitored via lumbar...
The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, are underrepresented TBI research. Therefore, we aimed to provide an overview health-care utilization, and six-month outcomes after their determinants who sustained TBI.We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) study. In-hospital post-hospital care utilization were...
To present population-based and age related incidence of surgery clinical outcome for adult patients operated hydrocephalus, registered in the Swedish Hydrocephalus Quality Registry (SHQR).All SHQR during 2004-2011 were included. Data on age, gender, type hydrocephalus extracted as well three months with idiopathic normal pressure (iNPH).The material consisted 2360 patients, 1229 men 1131 women, 63.8 ± 14.4 years (mean standard deviation (SD)). The mean total was 5.1 0.9...
Decompressive craniectomy (DC) in traumatic brain injury (TBI) has been suggested to influence cerebrovascular reactivity. We aimed determine if the statistical properties of vascular reactivity metrics and slow-wave relationships were impacted after DC, as such information would allow us comment on whether monitoring remains reliable craniectomy. Using CENTER-TBI High Resolution Intensive Care Unit (ICU) Sub-Study cohort, we selected those secondary DC patients with high-frequency...
Treatment and prevention of elevated intracranial pressure (ICP) is crucial in patients with severe traumatic brain injury (TBI). Elevated ICP associated secondary injury, both intensity duration an episode hypertension, often referred to as "ICP dose," are worse outcomes. Prediction such harmful episodes dose could allow for a more proactive preventive management TBI, potential implications on patients' The goal this study was develop validate machine-learning (ML) model predict potentially...
Abstract Background Morphological analysis of intracranial pressure (ICP) pulse waveforms provides indirect information on cerebrospinal compliance, which might be reduced by space-occupying lesions but also hypertension and aging. This study investigates the impact age mean ICP shape amplitude waveform in traumatic brain injury (TBI). Additionally, it explores association between morphological parameters mortality after TBI. Methods recordings from 183 TBI patients (median age: 50 (30, 61)...
There is little knowledge about the factors influencing long-term outcome after surgery for idiopathic normal pressure hydrocephalus (iNPH). To evaluate effects of reoperation due to complications and vascular comorbidity (hypertension, diabetes, stroke heart disease) on in iNPH patients, 2–6 years shunt surgery. We included 979 patients from Swedish Hydrocephalus Quality Registry (SHQR), operated during 2004–2011. The were followed yearly by mailed questionnaires, including a self-assessed...
Abstract Objective To describe survival and causes of death in 979 treated iNPH patients from the Swedish Hydrocephalus Quality Registry (SHQR), to examine influence comorbidities, symptom severity postoperative outcome. Methods All operated for 2004–2011 registered SHQR were included. A matched control group 4890 persons general population was selected by Statistics Sweden. Data Cause Death obtained controls. Results At a median 5.9 (IQR 4.2–8.1) year follow-up, 37% 23% controls had died....
Pressure reactivity index (PRx) and brain tissue oxygen (PbtO
Abstract Background After traumatic brain injury (TBI), fever is frequent. Brain temperature (BT), which directly linked to body temperature, may influence physiology. Increased and/or BT cause secondary damage, with deleterious effects on intracranial pressure (ICP), cerebral perfusion (CPP), and outcome. Methods Collaborative European NeuroTrauma Effectiveness Research in Traumatic Injury (CENTER-TBI), a prospective multicenter longitudinal study TBI Europe Israel, includes high resolution...
OBJECTIVE Intracranial pressure (ICP) pulse waveform analysis may provide valuable information about cerebrospinal pressure-volume compensation in patients with traumatic brain injury (TBI). The authors applied spectral methods to analyze ICP waveforms terms of the amplitude (AMP), high frequency centroid (HFC), and higher harmonics (HHC) also used a morphological classification approach assess changes shape using index (PSI). METHODS included 184 from Collaborative European NeuroTrauma...
Midline shift and mass lesions may occur with traumatic brain injury (TBI) are associated higher mortality morbidity. The shape of intracranial pressure (ICP) pulse waveform reflects the state cerebrospinal pressure-volume compensation which be disturbed by injury. We aimed to investigate link between ICP pathological computed tomography (CT) features.ICP recordings CT scans from 130 TBI patients CENTER-TBI high-resolution sub-study were analyzed retrospectively. shift, lesion volume,...
Importance The optimal timing for fixation of extremity fractures after traumatic brain injury (TBI) remains controversial. Objective To investigate whether patients who underwent within 24 hours TBI experienced worse outcomes than those had the procedure or more TBI. Design, Setting, and Participants This cohort study used data from Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Patients 16 years older with internal met inclusion...
Abstract Background Studies indicate that brain clearance via the glymphatic system is impaired in idiopathic normal pressure hydrocephalus (INPH). This has been suggested to result from reduced cerebrospinal fluid (CSF) turnover, which could be caused by a CSF formation rate. The aim of this study was determine rate cohort patients investigated for INPH and compare historical control cohort. Methods estimated 135 (75 ± 6 years old, 64/71 men/women) undergoing investigation INPH. A...
Object There are several infusion methods available to estimate the outflow conductance (C out ) or resistance (R = 1/C of CSF system. It has been stated that for unknown reasons, bolus method estimates a higher C than steady-state methods. The aim this study was compare different estimation . Methods following 3 were used: bol ); constant flow method, both static stat and dynamic dyn analyses; pressure cpi ). Repeated investigations performed on an experimental model with well-known...
OBJECTIVE Subdural hematoma (SDH) is the most common serious adverse event in patients with shunts. Adjustable shunts are used increasing frequency and make it possible to noninvasively treat postoperative SDH. The objective of this study was describe prevalence treatment preferences SDHs, based on fixed or adjustable shunt valves, a national cohort shunted idiopathic normal pressure hydrocephalus (iNPH), as well evaluate effect SDH long-term survival. METHODS Patients iNPH who received CSF...
Recent single-center retrospective analysis displayed the association between admission computed tomography (CT) markers of diffuse intracranial injury and worse cerebrovascular reactivity. The goal this study was to further explore these associations using prospective multi-center Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) high-resolution intensive care unit (HR ICU) data set. Using CENTER-TBI HR ICU sub-study cohort, we evaluated those...
Brain tissue oxygen (PbtO2) monitoring in traumatic brain injury (TBI) has demonstrated strong associations with global outcome. Additionally, PbtO2 signals have been used to derive indices thought be associated cerebrovascular reactivity TBI. However, their true relationship slow-wave vasogenic fluctuations cerebral autoregulation remains unclear. The goal of this study was investigate the between intracranial pressure (ICP), mean arterial (MAP) and over time. Using Collaborative European...
Traumatic brain injury (TBI) causes alteration in functions. Generally, at intensive care units (ICU), intracranial pressure (ICP) is monitored and treated to avoid increases ICP with associated poor clinical outcome. The aim was develop a model which could predict future levels of individual patients the ICU, warn treating clinicians before secondary injuries occur. A simple explainable, probabilistic Markov developed for prediction task ≥ 20 mmHg. Predictions were made 10-min intervals...