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5 results on '"lower limit of reactivity"'

1. The lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury: a CENTER-TBI high-resolution sub-study analysis

Author

Erta Beqiri, Frederick A. Zeiler, Ari Ercole, Michal M. Placek, Jeanette Tas, Joseph Donnelly, Marcel J. H. Aries, Peter J. Hutchinson, David Menon, Nino Stocchetti, Marek Czosnyka, Peter Smielewski, and CENTER-TBI HR ICU participants and investigators

Subjects
Lower limit of reactivity, Cerebral autoregulation, Traumatic brain injury, Individualised cerebral perfusion pressure, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong’s test. Results Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP

Published
2023
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2. The lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury: a CENTER-TBI high-resolution sub-study analysis.

Author

Beqiri, Erta, Zeiler, Frederick A., Ercole, Ari, Placek, Michal M., Tas, Jeanette, Donnelly, Joseph, Aries, Marcel J. H., Hutchinson, Peter J., Menon, David, Stocchetti, Nino, Czosnyka, Marek, Smielewski, Peter, Anke, Audny, Beer, Ronny, Bellander, Bo-Michael, Buki, Andras, Cabeleira, Manuel, Carbonara, Marco, Chieregato, Arturo, and Citerio, Giuseppe

Abstract

Background: A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods: Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong's test. Results: Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p = < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP. Conclusions: Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
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3. The lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury:a CENTER-TBI high-resolution sub-study analysis

Abstract

Background A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong’s test. Results Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p = < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP. Conclusions Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury., Background: A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods: Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong’s test. Results: Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p = < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP. Conclusions: Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury.

Published
2023

4. The lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury: a CENTER-TBI high-resolution sub-study analysis

Author

Beqiri, E, Zeiler, F, Ercole, A, Placek, M, Tas, J, Donnelly, J, Aries, M, Hutchinson, P, Menon, D, Stocchetti, N, Czosnyka, M, Smielewski, P, Anke, A, Beer, R, Bellander, B, Buki, A, Cabeleira, M, Carbonara, M, Chieregato, A, Citerio, G, Clusmann, H, Czeiter, E, Depreitere, B, Frisvold, S, Helbok, R, Jankowski, S, Kondziella, D, Koskinen, L, Kowark, A, Meyfroidt, G, Moeller, K, Nelson, D, Piippo-Karjalainen, A, Radoi, A, Ragauskas, A, Raj, R, Rhodes, J, Rocka, S, Rossaint, R, Sahuquillo, J, Sakowitz, O, Sundstrom, N, Takala, R, Tamosuitis, T, Tenovuo, O, Unterberg, A, Vajkoczy, P, Vargiolu, A, Vilcinis, R, Wolf, S, Younsi, A, Beqiri E., Zeiler F. A., Ercole A., Placek M. M., Tas J., Donnelly J., Aries M. J. H., Hutchinson P. J., Menon D., Stocchetti N., Czosnyka M., Smielewski P., Anke A., Beer R., Bellander B. -M., Buki A., Cabeleira M., Carbonara M., Chieregato A., Citerio G., Clusmann H., Czeiter E., Depreitere B., Frisvold S., Helbok R., Jankowski S., Kondziella D., Koskinen L. -O., Kowark A., Meyfroidt G., Moeller K., Nelson D., Piippo-Karjalainen A., Radoi A., Ragauskas A., Raj R., Rhodes J., Rocka S., Rossaint R., Sahuquillo J., Sakowitz O., Sundstrom N., Takala R., Tamosuitis T., Tenovuo O., Unterberg A., Vajkoczy P., Vargiolu A., Vilcinis R., Wolf S., Younsi A., Beqiri, E, Zeiler, F, Ercole, A, Placek, M, Tas, J, Donnelly, J, Aries, M, Hutchinson, P, Menon, D, Stocchetti, N, Czosnyka, M, Smielewski, P, Anke, A, Beer, R, Bellander, B, Buki, A, Cabeleira, M, Carbonara, M, Chieregato, A, Citerio, G, Clusmann, H, Czeiter, E, Depreitere, B, Frisvold, S, Helbok, R, Jankowski, S, Kondziella, D, Koskinen, L, Kowark, A, Meyfroidt, G, Moeller, K, Nelson, D, Piippo-Karjalainen, A, Radoi, A, Ragauskas, A, Raj, R, Rhodes, J, Rocka, S, Rossaint, R, Sahuquillo, J, Sakowitz, O, Sundstrom, N, Takala, R, Tamosuitis, T, Tenovuo, O, Unterberg, A, Vajkoczy, P, Vargiolu, A, Vilcinis, R, Wolf, S, Younsi, A, Beqiri E., Zeiler F. A., Ercole A., Placek M. M., Tas J., Donnelly J., Aries M. J. H., Hutchinson P. J., Menon D., Stocchetti N., Czosnyka M., Smielewski P., Anke A., Beer R., Bellander B. -M., Buki A., Cabeleira M., Carbonara M., Chieregato A., Citerio G., Clusmann H., Czeiter E., Depreitere B., Frisvold S., Helbok R., Jankowski S., Kondziella D., Koskinen L. -O., Kowark A., Meyfroidt G., Moeller K., Nelson D., Piippo-Karjalainen A., Radoi A., Ragauskas A., Raj R., Rhodes J., Rocka S., Rossaint R., Sahuquillo J., Sakowitz O., Sundstrom N., Takala R., Tamosuitis T., Tenovuo O., Unterberg A., Vajkoczy P., Vargiolu A., Vilcinis R., Wolf S., and Younsi A.

Abstract

Background: A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods: Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong’s test. Results: Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p = < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP. Conclusions: Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury.

Published
2023

5. The lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury:a CENTER-TBI high-resolution sub-study analysis

Abstract

Background A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong’s test. Results Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p = < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP. Conclusions Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury., Background: A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods: Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong’s test. Results: Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p = < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP. Conclusions: Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury.

Published
2023

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