.jpeg.jpg "Sergio Brasil, MD, PhD photo")
Sergio Brasil, MD, PhD
University of Sao Paulo
Sao Paulo, Brazil
Disclosure information not submitted.
Sergio Brasil, MD, PhD
University of Sao Paulo
Sao Paulo, Brazil
Disclosure information not submitted.
Title: Intracranial pressure variations assessed by invasive and noninvasive techniques
Background: Intracranial pressure waveform (ICPW) is an indicator of impaired intracranial compliance (ICC). ICPW has shown to behave differently among closed skulls and craniectomized patients. The aim of the present study was to determine whether a recently developed noninvasive new technology for ICC monitoring (B4C) could reproduce Invasive ICPW dynamics in patients with a variety of diagnosis and even after decompressive craniectomy.
Methods: Neurocritical patients under ICP monitoring were consecutively included for the evaluation with B4C sensor concomitantly. An ultrasound guided internal jugular veins (IJVs) compression was performed for elevation of ICP from baseline. ICP values, amplitudes of the peaks found in ICP and B4C waveforms (P2/P1 ratio) were analyzed.
Results: Among 45 patients, traumatic brain injury, subarachnoid hemorrhage, and stroke were among the main causes for ICP monitoring. Correlation between ICP and B4C waveforms was very strong for ICP P2/P1 ratio >1 and B4C P2/P1 ratio >1.2 (AUC .84). The induced elevation of ICP was compatible with strong correlation tendency between both techniques ICP waveforms (AUC .86). Patients with decompressive craniectomy presented baseline higher P2/P1 ratio in comparison with those that had closed skull (p= 0.03). Likewise, a decrease in P2/P1 ratio with induced ICP elevation was observed from both techniques (p=0.001).
Conclusion: In this study with ICP induced elevation, the waveforms obtained from the novel noninvasive technique that detects cranial deformation disclosed similar behavior with intracranial pressure invasive waveforms. This new technology is promising to expand applicability of intracranial compliance monitoring in critical care.