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Funding Agency and Grant Number: [NIHR01 NS082309]
Funding text: This study was supported in part by NIHR01 NS082309 (WAK and RB) .
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Balu, Ramani
Cerebrovascular pressure reactivity and intracranial pressure are associated with neurologic outcome after hypoxic-ischemic brain injury
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Aim: We evaluated the association of physiological parameters measured by intracranial multimodality neuromonitoring with neurologic outcome in a consecutive series of patients with hypoxic-ischemic brain injury (HIBI).Methods: We retrospectively identified all patients with HIBI who underwent combined invasive intracranial pressure (ICP) and brain tissue oxygen (PbtO2) monitoring over a 3 year period. Cerebrovascular pressure reactivity index (PRx) was calculated continuously as a surrogate of cerebral autoregulation. Favorable outcome was defined as recovery of consciousness (Glasgow Coma Scale motor score = 6). Differences in mean ICP, PRx and PbtO2 for the entire monitoring period across outcomes were measured. Logistic regression and area under receiver operating characteristic (AUROC) curve were used to assess the association of each monitoring parameter with neurologic outcome.Results: We analyzed data from 36 patients. Most (89%) had an antecedent sudden cardiac arrest. Favorable outcome occurred in 8 (22%) patients. ICP and PRx were higher in patients with unfavorable outcome (ICP: 26 +/- 4.1 mmHg vs 7.5 +/- 2 mmHg, p = 0.0002; PRx: 0.51 +/- 0.05 vs 0.11 +/- 0.05, p < 0.0001). There was no significant difference in PbtO2 between groups (unfavorable: 20 +/- 2.4 mmHg vs favorable: 25 +/- 1.5 mmHg, p = 0.12). Both ICP (AUROC 0.84, 95%CI 0.72-0.98, p = 0.003) and PRx (AUROC 0.94, 95%CI 0.85-1, p = 0.0002) discriminated between favorable and unfavorable outcome, in contrast to PbtO2, (AUROC 0.59, 95%CI 0.39-0.78, p = 0.52). ICP > 15 mmHg, PRx > 0.2, and PbtO2 < 18 mmHg had sensitivity/specificity of 68%/100%, 89%/88%, and 40%/100% respectively for discriminating outcomes.Conclusion: Cerebrovascular pressure reactivity and intracranial pressure appear to be associated with neurologic outcome in patients with HIBI.
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/api/publication/32439144
<div class="JournalArticle Publication short-list"> <div class="authors"> <span class="author-name" > Balu, Ramani ✉ </span> <span class="author-type"> </span> ; <span class="author-name" > Rajagopalan, Swarna </span> <span class="author-type"> </span> ; <span class="author-name" > Baghshomali, Sanam </span> <span class="author-type"> </span> ; <span class="author-name" > Kirschen, Matthew </span> <span class="author-type"> </span> ; <span class="author-name" > Amurthur, Ashwin </span> <span class="author-type"> </span> ; <span class="author-name" > Kofke, W. Andrew </span> <span class="author-type"> </span> ; <span class="author-name" > Abella, Benjamin S. </span> <span class="author-type"> </span> </div ><div class="title"><a href="/gui2/?mode=browse¶ms=publication;32439144" mtid="32439144" target="_blank">Cerebrovascular pressure reactivity and intracranial pressure are associated with neurologic outcome after hypoxic-ischemic brain injury</a></div> <div class="pub-info"> <span class="journal-title">RESUSCITATION</span> <span class="journal-volume">164</span> <span class="page"> pp. 114-121. , 8 p. </span> <span class="year">(2021)</span> </div> <div class="pub-end"><div class="identifier-list"> <span class="identifiers"> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="10.1016/j.resuscitation.2021.04.023" target="_blank" href="https://doi.org/10.1016/j.resuscitation.2021.04.023"> DOI </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="000661807100001" target="_blank" href="https://www.webofscience.com/wos/woscc/full-record/000661807100001"> WoS </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="85105507486" target="_blank" href="http://www.scopus.com/record/display.url?origin=inward&eid=2-s2.0-85105507486"> Scopus </a> </span> <span class="id identifier oa_none" title="none"> <a style="color:blue" title="33930501" target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=33930501&dopt=Abstract"> PubMed </a> </span> </span> </div> <div class="short-pub-prop-list"> <span class="short-pub-mtid"> Publication:32439144 </span> <span class="status-holder"><span class="status-data status-VALIDATED"> Validated </span></span> <span class="pub-core"> Citing </span> <span class="pub-type">Journal Article (Article ) </span> <!-- && !record.category.scientific --> <span class="pub-category">Scientific</span> </div> </div> </div><div class="JournalArticle Publication long-list">
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<img title="Idézőközlemény" style="float: left" src="/frontend/resources/grid/publication-citation-icon.png">
<div class="autype autype0"> <span class="author-name" >Balu Ramani ✉
</span>
;
<span class="author-name" >Rajagopalan Swarna
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;
<span class="author-name" >Baghshomali Sanam
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;
<span class="author-name" >Kirschen Matthew
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;
<span class="author-name" >Amurthur Ashwin
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;
<span class="author-name" >Kofke W. Andrew
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;
<span class="author-name" >Abella Benjamin S.
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</div>
<div class="title"><a href="/gui2/?mode=browse¶ms=publication;32439144" target="_blank">Cerebrovascular pressure reactivity and intracranial pressure are associated with neurologic outcome after hypoxic-ischemic brain injury</a></div> <div> <span class="journal-title">RESUSCITATION</span>
<span class="journal-issn">(<a target="_blank" href="https://portal.issn.org/resource/ISSN/0300-9572">0300-9572</a> <a target="_blank" href="https://portal.issn.org/resource/ISSN/1873-1570">1873-1570</a>)</span>:
<span class="journal-volume">164</span>
<span class="page">
pp 114-121
</span> <span class="year">(2021)</span>
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<span class="language" xmlns="http://www.w3.org/1999/html">Language:
English
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<a target="_blank" href="/api/publication?cond=citations.related;eq;32439144&sort=publishedYear,desc&sort=title">
Number of cited publications: 1
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<div class="mtid"><span class="long-pub-mtid">Publication: 32439144</span>
| <span class="status-data status-VALIDATED"> Validated
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<div class="lastModified">Last Modified: 2021.10.17. 01:55 API MTMT (MTMT API user, admin)
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<pre class="comment" style="margin-top: 0; margin-bottom: 0;"><u>Comments</u>: Funding Agency and Grant Number: [NIHR01 NS082309]
Funding text: This study was supported in part by NIHR01 NS082309 (WAK and RB) .</pre>
</div></div>