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J Clin Monit Comput · Apr 2021
LetterAnti-decubitus bed mattress may interfere with cerebrovascular pressure reactivity measures due to induced ICP and ABP cyclic peaks.
- Tas Jeanette, Borg Melisa, Smielewski Peter, Czosnyka Marek, Beqiri Erta, Ercole Ari, and Aries Marcel.
- Department of Intensive Care, University of Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands. jeanette.tas@mumc.nl.
- J Clin Monit Comput. 2021 Apr 1; 35 (2): 423-425.
AbstractSevere traumatic brain injury (TBI) patients are monitored with continuous arterial blood pressure (ABP) and intracranial pressure (ICP). The pressure reactivity index (PRx) is a frequently used correlation coefficient between ABP and ICP to inform clinicians at the bedside about trends in global cerebrovascular pressure regulation status. We present an unexpected influence of cyclic anti-decubitus mattress inflations and deflations on invasive ICP, ABP and PRx calculations in our TBI patients. This might affect autoregulation guided management. In our database, 23% (9/39) of the patients show recurrent peaks in the monitoring signals. We hypothesize that these peaks are caused by (a combination) of hydrostatic change, local (cervical) compression and/or incorrect sensor zeroing due to positional changes induced by the anti-decubitus mattress. This warrants further investigation by the manufacturer and exploration of data filters.
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