A5089198173- Traumatic Brain Injury and Neurovascular Disturbances
- Optical Imaging and Spectroscopy Techniques
- Cardiac Arrest and Resuscitation
- Traumatic Brain Injury Research
- Acute Ischemic Stroke Management
- S100 Proteins and Annexins
- Hemodynamic Monitoring and Therapy
- Cerebrospinal fluid and hydrocephalus
- Neurosurgical Procedures and Complications
- Sepsis Diagnosis and Treatment
- Intracranial Aneurysms: Treatment and Complications
- Cardiac, Anesthesia and Surgical Outcomes
- Intensive Care Unit Cognitive Disorders
- Long-Term Effects of COVID-19
- Radiation Dose and Imaging
- Cerebral Venous Sinus Thrombosis
- Intracerebral and Subarachnoid Hemorrhage Research
- Cardiovascular and Diving-Related Complications
- Stroke Rehabilitation and Recovery
- Thermal Regulation in Medicine
- Cerebrovascular and Carotid Artery Diseases
- Spinal Fractures and Fixation Techniques
- Mechanical Circulatory Support Devices
- Aortic Disease and Treatment Approaches
- Sinusitis and nasal conditions
Maastricht University
2017-2025
Maastricht University Medical Centre
2017-2024
University of Cambridge
2011-2022
University Medical Center
2022
Addenbrooke's Hospital
2013-2022
University of Antwerp
2022
Antwerp University Hospital
2022
University of British Columbia
2018
University of Genoa
2018
University of Auckland
2018
Objectives: We have sought to develop an automated methodology for the continuous updating of optimal cerebral perfusion pressure (CPPopt) patients after severe traumatic head injury, using monitoring cerebrovascular reactivity. then validated CPPopt algorithm by determining association between outcome and deviation actual CPP from CPPopt. Design: Retrospective analysis prospectively collected data. Setting: Neurosciences critical care unit a university hospital. Patients: A total 327...
Managing traumatic brain injury (TBI) patients with a cerebral perfusion pressure (CPP) near to the autoregulation (CA)-guided "optimal" CPP (CPPopt) value is associated improved outcome and might be useful individualize care, but has never been prospectively evaluated. This study evaluated feasibility safety of CA-guided management in TBI requiring intracranial monitoring therapy (TBIicp patients). The CPPopt Guided Therapy: Assessment Target Effectiveness (COGiTATE) parallel two-arm trial...
Objectives: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular reactivity index has the potential to provide a personalized treatment target improve patient outcomes. So far, methods have focused identifying “one” autoregulation-guided target—called “cerebral optimal”. We investigated whether autoregulation range—which uses continuous estimation of “lower” and “upper” limits (assessed with index)—has prognostic value. Design: Single-center...
Abstract BACKGROUND Intracranial pressure (ICP) is a clinically important variable after severe traumatic brain injury (TBI) and has been monitored, along with clinical outcome, for over 25 yr in Addenbrooke's hospital, Cambridge, United Kingdom. This time period also seen changes management strategies the implementation of protocolled specialist neurocritical care, expansion neuromonitoring techniques, adjustments treatment targets. OBJECTIVE To describe intracranial monitoring variables...
Introduction Individualising therapy is an important challenge for intensive care of patients with severe traumatic brain injury (TBI). Targeting a cerebral perfusion pressure (CPP) tailored to optimise cerebrovascular autoregulation has been suggested as attractive strategy on the basis large body retrospective observational data. The objective this study prospectively assess feasibility and safety such compared fixed thresholds which current standard from international consensus...
Several methods have been proposed to measure cerebrovascular autoregulation (CA) in traumatic brain injury (TBI), but the lack of a gold standard and absence prospective clinical data on risks, impact care outcomes implementation CA-guided management lead uncertainty.To formulate statements using Delphi consensus approach employing group expert clinicians, that reflect current knowledge CA, aspects can be implemented TBI CA research priorities.A 25 international academic experts with...
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 aim of this panel was to develop consensus recommendations on targeted temperature control (TTC) in patients with severe traumatic brain injury (TBI) and moderate TBI who deteriorate require admission the intensive care unit for intracranial pressure (ICP) management.
Introduction Multimodality monitoring is regularly employed in adult traumatic brain injury (TBI) patients where it provides physiologic and therapeutic insight into this heterogeneous condition. Pediatric studies are less frequent. Methods An analysis of data collected prospectively from 12 pediatric TBI admitted to Addenbrooke’s Hospital, Intensive Care Unit (PICU) between August 2012 December 2014 was performed. Patients’ intracranial pressure (ICP), mean arterial (MAP), cerebral...
Abstract Background Near-infrared spectroscopy regional cerebral oxygen saturation (rSO 2 ) has gained interest as a raw parameter and basis for measuring cerebrovascular reactivity (CVR) due to its noninvasive nature high spatial resolution. However, the prognostic utility of these parameters not yet been determined. This study aimed identify threshold values rSO -based CVR at which outcomes worsened following traumatic brain injury (TBI). Methods A retrospective multi-institutional cohort...
Abstract Background Numerous trials have addressed intracranial pressure (ICP) management in neurocritical care. However, identifying its harmful thresholds and controlling ICP remain challenging terms of improving outcomes. Evidence suggests that an individualized approach is necessary for establishing tolerance limits ICP, incorporating factors such as waveform (ICPW) or pulse morphology along with additional data provided by other invasive (e.g., brain oximetry) noninvasive monitoring...
Methods to identify an autoregulation guided "optimal" cerebral perfusion pressure (CPPopt) for traumatic brain injury patients (TBI) have been reported through several studies. An important drawback of existing methodology is that CPPopt can be calculated only in ∼50-60% the monitoring time. In this study, we hypothesized yield and continuity improved significantly application a multi-window weighting calculation algorithm, without adversely affecting preservation its prognostic value. Data...
We aimed to assess the reliability and validity of Therapy Intensity Level scale (TIL) for intracranial pressure (ICP) management. reviewed medical records 31 patients with traumatic brain injury (TBI) in two European intensive care units (ICUs). The ICP TIL was derived over a 4-day period 4-h (TIL4) 24-h epochs (TIL24). scores were compared historical schemes measurement, each other, clinical variables. TIL24 ICU TBI control groups: extracranial trauma necessitating (Trauma_ICU; n = 20) not...