The Relationship Between Cerebral Blood Flow Autoregulation and Cerebrovascular Pressure Reactivity After Traumatic Brain Injury

• DOI: 10.1227/neu.0b013e318260feb1
• Publication Date: 2012-05-31T07:04:45Z
• Authors: Karol P. Budohoski; Marek Czosnyka; Nicolas de Riva; Peter Smielewski; John D. Pickard; David K. Menon; Peter J. Kirkpatrick; Andrea Lavinio
• Keywords: Cerebral autoregulation; Transcranial Doppler

BACKGROUND: Cerebrovascular pressure reactivity is the principal mechanism of cerebral autoregulation. Assessment autoregulation can be performed by using mean flow index (Mx) based on transcranial Doppler ultrasonography. monitored (PRx), which intracranial monitoring. From a practical point view, PRx continuously, whereas Mx only in short periods when probes applied. OBJECTIVE: To assess to what degree impairment (PRx) associated with (Mx). METHODS: A database 345 patients traumatic brain injury was screened for data availability including simultaneous and Absolute differences, temporal changes, association outcome 2 indices were analyzed. RESULTS: total 486 recording sessions obtained from 201 available analysis. Overall moderate correlation between found (r = 0.58; P < .001). The area under receiver operator characteristic curve designed detect ability predict impaired 0.700 (95% confidence interval: 0.607-0.880). Discrepancies most pronounced at an 30 mm Hg they significantly larger who died (P .026). Both lower day 1 postadmission survived than those .01). CONCLUSION: There agreement PRx. are particularly significant sustained hypertension. However, clinical purposes, there limited interchangeability indices. ABBREVIATIONS: ABP, arterial blood BF, CBV, volume CPP, perfusion FV, velocity GCS, Glasgow Coma Scale GOS, Outcome ICP, Mx, PRx, ROC, TBI, TCD,