A5075321933- Traumatic Brain Injury and Neurovascular Disturbances
- Traumatic Brain Injury Research
- Cardiac Arrest and Resuscitation
- Hemodynamic Monitoring and Therapy
- Meta-analysis and systematic reviews
- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- Dysphagia Assessment and Management
- Heart Rate Variability and Autonomic Control
- Cardiovascular Syncope and Autonomic Disorders
- Tracheal and airway disorders
- Esophageal and GI Pathology
- Health Systems, Economic Evaluations, Quality of Life
- Cerebrospinal fluid and hydrocephalus
- Non-Invasive Vital Sign Monitoring
- Sepsis Diagnosis and Treatment
- Intensive Care Unit Cognitive Disorders
- Botulinum Toxin and Related Neurological Disorders
- Radiation Dose and Imaging
- Intracranial Aneurysms: Treatment and Complications
- Clinical Nutrition and Gastroenterology
- Statistical Methods in Clinical Trials
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Long-Term Effects of COVID-19
- Neurosurgical Procedures and Complications
Copenhagen University Hospital
2019-2025
Rigshospitalet
2016-2025
Glostrup Hospital
2014-2024
University of Copenhagen
2018-2023
Institut des Sciences Cognitives Marc Jeannerod
2023
Hvidovre Hospital
2013-2022
Abstract The mean flow index—usually referred to as Mx—has been used for assessing dynamic cerebral autoregulation (dCA) almost 30 years. However, concerns have arisen regarding methodological consistency, construct and criterion validity, test–retest reliability. Methodological nuances, such choice of input (cerebral perfusion pressure, invasive or non‐invasive arterial pressure), pre‐processing approach artefact handling, significantly influence index values, previous studies correlating...
Abstract Background The harm‐benefit balance for early out‐of‐bed mobilisation of patients with severe acquired brain injury (ABI) in neurointensive care units (neuro‐ICUs) is unclear, and there are no clinical guidelines. This study aimed to survey the current practice perceptions among clinicians involved first Scandinavian neuro‐ICUs. Methods was a cross‐sectional, anonymous, web‐based survey; reporting follows recommended CROSS checklist. Clinicians all 14 neuro‐ICUs were eligible...
Objective: To examine an early decannulation protocol in adult severe acquired brain injury (SABI) patients. Design: Retrospective, observational cohort study. Subjects/patients: Tracheotomized SABI patients ≥ 18 years admitted to a neurorehabilitation unit. Methods: Primary outcome measure was difference survival rate within first year of discharge. Secondary measures were respiratory infections treated with antibiotics, re-cannulation, time from admission decannulation, length stay,...
Background Research in animal models on cerebral metabolism after brain injury highlights the potential benefits of ketosis reducing secondary injury, but studies humans are lacking. Aim This study aimed to examine if a 6-week ketogenic diet intervention with added medium-chain triglycerides (MCT) was feasible adult patients acquired subacute phase, whether could be achieved and maintained, what extent serious adverse reactions, events, events occured. Methods Patients ≥18 years age...
Early mobilization is of importance for improving long-term outcome patients after severe acquired brain injury. A limiting factor early by head-up tilt orthostatic intolerance. The purpose the present study was to examine cerebral autoregulation in with injury and a low level consciousness. Fourteen intolerance fifteen healthy volunteers were enrolled. Blood pressure evaluated pulse contour analysis, heart rate RR-intervals determined electrocardiography, middle artery velocity transcranial...
Abstract Transfer function analysis (TFA) is a widely used method for assessing dynamic cerebral autoregulation in humans. In the present study, we assessed test–retest reliability of established TFA metrics derived from spontaneous blood pressure oscillations and based on 5 min recordings. The TFA‐based gain, phase coherence low‐frequency range (0.07–0.20 Hz) 19 healthy volunteers, 37 patients with subarachnoid haemorrhage sepsis were included. Reliability assessments included smallest real...
Abstract Patients with severe traumatic brain injury (TBI) may have autonomic dysfunction, one manifestation of which is orthostatic intolerance. This potentially impairs physical rehabilitation. However, the exact mechanisms remain elusive. In 30 patients participating in a trial early tilt training versus standard care and 15 healthy volunteers, 5‐min electrocardiography was recorded supine position during 70° head‐up tilt. Heart rate variability analyzed by low‐ high‐frequency (LF HF)...
Background: Intensive rehabilitation of patients after severe traumatic brain injury aims to improve functional outcome. The effect initiating in the early phase, form head-up mobilization, is unclear. Objective: To assess whether mobilization feasible and safe with admitted a neurointensive care unit. Methods: This was randomized parallel-group clinical trial, including (Glasgow coma scale <11 admission unit). intervention consisted daily on tilt-table for 4 weeks. control group...
Background Mean flow index (Mxa) for evaluating dynamic cerebral autoregulation is derived using varying approaches calculation, which may explain that the reliability ranges from poor to excellent. The comparability, repeatability, stability, and internal consistency of have not previously been assessed. Methods We included 60 recordings resting healthy volunteers calculated Mxa four different approaches: three without overlapping calculations, intervals averaging wave-form data (blocks) 3,...
Introduction Dysphagia is a common and critical consequence of acquired brain injury (ABI) can cause severe complications. rehabilitation transforming from mainly compensatory strategies to the retraining swallowing function using principles neuroscience. However, there are no studies that map interventions available retrain in patients with moderate-to-severe ABI. Objective To systematically accessible research literature answer question: Which non-surgical, non-pharmacological used...
BACKGROUND: There is little high-level evidence for the effect of nonverbal facilitation swallowing on ability in subacute stage rehabilitation following severe acquired brain injury (ABI). OBJECTIVE: To pilot test a randomis
Dynamic cerebral autoregulation to spontaneous fluctuations in perfusion pressure (CPP) is often assessed by transcranial Doppler (TCD) the time domain, yielding primarily mean flow index (Mx), or frequency domain using transfer function analysis (TFA), gain and phase. For both domains, measurement of blood critical. This study inter-method reliability dynamic three different methods measurement. In 39 patients with aneurysmal subarachnoid hemorrhage, non-invasive arterial (ABP), invasive...
Intensive rehabilitation of patients with severe traumatic brain injury is generally applied in the subacute stages hospital stay. Few studies have assessed association between early and intensive physical functional outcomes. The aim this trial to assess feasibility an intervention focusing on mobilisation upright position, starting as clinically possible versus standard care unit. study intended inform a subsequent randomised clinical that will investigate benefits harms intervention. This...
Abstract Objective . Invasively measured arterial blood pressure (ABP) is associated with complications, while non-invasively ABP generally considered risk-free. This study aimed to investigate the reliability of non-invasive using finger-cuff volume-clamp device compared invasive by an catheter in patients aneurysmal subarachnoid haemorrhage (SAH). Approach In 30 admitted for neurointensive care SAH, and were recorded simultaneously. Reliability was assessed mean, diastolic systolic...
Dynamic cerebral autoregulation is often assessed by continuously recorded arterial blood pressure (ABP) and transcranial Doppler-derived mean flow velocity followed analysis in the time frequency domain, respectively. Sequential correlation (in yielding e.g., measure index, Mxa) transfer function (TFA) yielding, normalised non-normalised gain as well phase low domain) are commonly used approaches. This study investigated diagnostic prognostic performance of these metrics. We included...
Patients with aneurysmal subarachnoid haemorrhage (SAH) might have impaired cerebral autoregulation, that is, CBF - and thereby oxygen delivery passively increase an in CPP. This physiological study aimed to investigate the haemodynamic effects of controlled blood pressure early phase after SAH before any signs delayed ischaemia (DCI) occurred.The was carried out within 5 days ictus. Data were recorded at baseline 20 min noradrenaline infusion mean arterial (MAP) by a maximum 30 mmHg...
In patients with severe traumatic brain injury, there is limited evidence of the clinical effect early orthostatic exercise, although such exercise may strengthen systemic or cerebral hemodynamic responses to head-up tilt, thereby minimizing intolerance. We measured dynamic autoregulation (dCA) and occurrence intolerance after four weeks regular by tilt using a table integrated stepping ERIGO® tilt-table comparing it standard care. Thirty-four injury admitted neurocritical care unit were...