• Neurological research · Jul 2007

    Online correlation of spontaneous arterial and intracranial pressure fluctuations in patients with diffuse severe head injury.

    • Michael Reinert, Robert H Andres, Martin Fuhrer, Alexander Müller, Benoit Schaller, and HansRuedi Widmer.
    • Department of Neurosurgery, Inselspital Bern, University of Bern, 3010 Bern, Switzerland. michael.reinert@neurochirurgie-bern.ch
    • Neurol. Res. 2007 Jul 1; 29 (5): 455-62.

    AbstractDetermination of relevant clinical monitoring parameters for helping guide the intensive care therapy in patients with severe head injury, is one of the most demanding issues in neurotrauma research. New insights into cerebral autoregulation and metabolism have revealed that a rigid cerebral perfusion pressure (CPP) regimen might not be suitable for all severe head injured patients. We thus developed an online analysis technique to monitor the correlation (AI rho) between the spontaneous fluctuations of the mean arterial blood pressure (MABP) and the intracranial pressure (ICP). In addition, brain tissue oxygen (PtiO2) and metabolic microdialysate measures including glucose and lactate were registered. We found that in patients with good outcome, the AI rho values were significantly lower as compared with patients with poor outcome. Accordingly, microdialysate glucose and lactate were significantly higher in the good outcome group. We conclude that online determination of AI rho offers a valuable additional and technically easily performable tool for guidance of therapy in patients with severe head injury.

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