• Kevin N Sheth, Deborah M Stein, Bizhan Aarabi, Peter Hu, Joseph A Kufera, Thomas M Scalea, and Daniel F Hanley.
• Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA. ksheth@som.umaryland.edu
• Neurocrit Care. 2013 Feb 1;18(1):26-32.

ObjectiveDetecting and treating elevated intracranial pressure (ICP) is a cornerstone of management in patients with severe traumatic brain injury. The aim of this study was to determine the association between area under the curve measurement of elevated ICP and clinical outcome.MethodsSingle center observational study using prospectively collected data at a University hospital, level one-trauma center. Sixty prospective patients with severe traumatic brain injury were prospectively enrolled over a 2-year period. Intracranial pressure measurements were captured using a real-time automated, high resolution vital signs data recording system. Mortality and functional outcome were assessed at 30 days, 3 and 6 months using Extended Glasgow Outcome Scale.ResultsIncreasing elevated intracranial pressure time dose was associated with mortality (OR 1.08; 95 % confidence interval [CI], 1.01-1.15, p = 0.03) and poor functional outcome at 3 (OR 1.04; CI 1.00-1.07, p = 0.03) and 6 months (1.04; CI 1.01-1.08, p = 0.02). However, there was no association between episodic ICP data and outcome.ConclusionsThese results suggest that pressure time dose measurement of intracranial pressure may be used to predict outcome in severe traumatic brain injury and may be a candidate biomarker in this disease.

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