• Alfred P Bowles, Lisa Pasierb, Thomas Simunich, and Monica Updyke.
• Conemaugh Valley Memorial Hospital, Johnstown, PA, USA.
• Brain Inj. 2012 Jan 1;26(12):1415-24.

Primary ObjectiveTo determine whether neurophysiologic parameters-intracranial pressure (ICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), partial brain tissue oxygenation (PbtO(2)) and pressure reactivity index (PRx, calculated)-captured during the management of traumatic brain injury (TBI) have a relationship to patient outcome.Research DesignA retrospective analysis of neurophysiologic data collected from persons under medical management of TBI per Conemaugh Memorial Medical Center (CMMC) standard treatment algorithms.Methods And ProceduresNine patients' medical records that matched International Statistical Classification of Diseases and Related Health Problems (ICD-9) code for head injury and a Current Procedural Terminology (CPT) code for an ICP monitoring device or ventriculostomy were analysed on the aforementioned parameters.Main Outcomes And ResultsStatistical significance by mortality (α = 0.05) was found for ICP, CPP and PbtO(2). PRx showed a pattern of significance over the last 72 hours. The couplets (CPP & ICP) and (CPP & MAP) demonstrated significant correlations.ConclusionsImproved autoregulation was associated with PRx values near zero. Controlling those parameters that affect PRx, namely MAP, ICP and CPP and more importantly cerebral oxygen perfusion (COP), would likely increase the probability of a better outcome while guarding against secondary insult.

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