医学
脑自动调节
自动调节
颅内压
脑血流
脑灌注压
心脏病学
经颅多普勒
大脑中动脉
内科学
血压
灌注
冲程(发动机)
麻醉
缺血
机械工程
工程类
作者
Bernhard Schmidt,Marek Czosnyka,Andreas Raabe,Hilal Yahya,Jens Schwarze,Dieter Sackerer,Dirk Sander,Jürgen Klingelhöfer
出处
期刊:Stroke
[Ovid Technologies (Wolters Kluwer)]
日期:2003-01-01
卷期号:34 (1): 84-89
被引量:105
标识
DOI:10.1161/01.str.0000047849.01376.ae
摘要
A mathematical model has previously been introduced to estimate noninvasively intracranial pressure (nICP). In the present multicenter study, we investigated the ability of model to adapt to the state of cerebral autoregulation (SCA). This modification was intended to improve the quality of nICP estimation and noninvasive assessment of pressure reactivity of the cerebrovascular system.We studied 145 patients after severe head injuries or stroke. All patients had direct ICP, arterial blood pressure (ABP), and transcranial Doppler middle cerebral artery blood flow velocity (FV) monitored. The SCA was assessed by moving correlation (Mx index) of cerebral perfusion pressure (CPP=ABP-ICP) and cerebral blood flow velocity and correlation of ABP and ICP (PRx index). nICP was calculated from ABP and FV waveforms. When nICP was used instead of ICP, the SCA was continuously estimated, and the model was dynamically adapted to the SCA.High and moderate correlations between invasively (Mx, PRx) and noninvasively (nMx, nPRx) estimated autoregulation indexes were observed (Mx: R=0.90, P<0.001; PRx: R=0.62, P<0.001). Values of Mx and nMx indicated contradictory SCA in 4 of 167 evaluated recordings; values of PRx and nPRx were contradictory in 27 recordings. When the model was adapted to the SCA, the mean error of ICP estimation decreased significantly (P<0.005).Continuous adaptation of the model to SCA improves the accuracy of noninvasive estimation of ICP and ICP dynamics. The same model provides a noninvasive and continuous assessment of SCA.
科研通智能强力驱动
Strongly Powered by AbleSci AI