Influence of patient demographics on optimal cerebral perfusion pressure following traumatic brain injury

Young, J., Moss, L. , Shaw, M., Cahya, E., Kommer, M. and Hawthorne, C. (2021) Influence of patient demographics on optimal cerebral perfusion pressure following traumatic brain injury. In: Depreitere, B., Meyfroidt, G. and Güiza, F. (eds.) Intracranial Pressure and Neuromonitoring XVII. Series: Acta neurochirurgica supplement (131). Springer: Cham, pp. 153-158. ISBN 9783030594350 (doi: 10.1007/978-3-030-59436-7_31)

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Abstract

The relationship between optimal cerebral perfusion pressure (CPPopt) and patient characteristics has yet to be defined but could have significant implications for future guidelines recommending cerebral perfusion pressure (CPP) targets. Data from 36 traumatic brain injured patients admitted to neurological intensive care were analysed retrospectively. Linear mixed effects (LME) analysis was performed using an unadjusted-adjusted approach. Clinical characteristics with p < 0.10 were included in the adjusted model. A second adjusted model which included all variables of interest was created. Model fit was assessed using the root-mean-square error (RMSE). The adjusted model included time from initiation of intracranial pressure (ICP) monitoring (estimate = 0.00292, p < 0.001), age (estimate = −0.211, p = 0.0750) and the presence of diffuse axonal injury (DAI) (estimate = −35.5, p < 0.001). The RMSE of this model was 8.11 mmHg. The RMSE of the model containing all variables was 8.09 mmHg. Time, age and the presence of DAI may be important predictors of CPPopt. The models were too inaccurate at predicting CPPopt for employment in clinical practice but warrant further investigation. CPPopt is a dynamic measurement influenced by many factors, supporting the utility of investigating the feasibility of CPPopt-guided therapy.

Item Type:Book Sections
Additional Information:Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 131).
Status:Published
Glasgow Author(s) Enlighten ID:Kommer, Maya and Hawthorne, Dr Christopher and Moss, Dr Laura and Shaw, Dr Martin
Authors: Young, J., Moss, L., Shaw, M., Cahya, E., Kommer, M., and Hawthorne, C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Publisher:Springer
ISBN:9783030594350
Published Online:11 April 2021
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