ArticleNeurocritical care2014
Should the neurointensive care management of traumatic brain injury patients be individualized according to autoregulation status and injury subtype?
Article in Neurocritical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Cerebral Autoregulation in Severe Traumatic Brain Injury: Source of Index, Timing, and Relationship to Spreading Depolarization.Journal of neurotrauma · 2026Article
- Intracranial pressure physiology, monitoring and individualized management in the acute brain injured patient.Intensive care medicine · 2026Review
- Intracranial Pressure Thresholds for Cerebral Autoregulation Impairment: Age-Stratified Analysis of Ultra-Low-Frequency Pressure Reactivity Index (UL-PRx) in Traumatic Brain Injury.Neurocritical care · 2025Article
- Should Patients with Traumatic Brain Injury with Significant Contusions be Treated with Different Neurointensive Care Targets?Neurocritical care · 2024Observational
- Lung Injury Risk in Traumatic Brain Injury Managed With Optimal Cerebral Perfusion Pressure Guided-Therapy.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2023Article
- Article
- Cerebrovascular Pressure Reactivity Measures: Index Comparison and Clinical Outcome in Patients With Traumatic Brain Injury Treated According to an Intracranial Pressure-Focused Management: Rejection of the Null Hypothesis.Neurotrauma reports · 2023Article
- Continuous Assessment of "Optimal" Cerebral Perfusion Pressure in Traumatic Brain Injury: A Cohort Study of Feasibility, Reliability, and Relation to Outcome.Neurocritical care · 2019Article
- Cerebral Blood Flow Autoregulation in Sepsis for the Intensivist: Why Its Monitoring May Be the Future of Individualized Care.Journal of intensive care medicine · 2018Review
- Comparing Plasma Phospho Tau, Total Tau, and Phospho Tau-Total Tau Ratio as Acute and Chronic Traumatic Brain Injury Biomarkers.JAMA neurology · 2017Article
- Temporal profile of intracranial pressure and cerebrovascular reactivity in severe traumatic brain injury and association with fatal outcome: An observational study.PLoS medicine · 2017Observational
- Aspects on the Physiological and Biochemical Foundations of Neurocritical Care.Frontiers in neurology · 2017Review
- Detection of Impaired Cerebral Autoregulation Using Selected Correlation Analysis: A Validation Study.Computational and mathematical methods in medicine · 2017Article
- Cerebral blood flow and autoregulation: current measurement techniques and prospects for noninvasive optical methods.Neurophotonics · 2016Article
- Visualizing secondary brain insults: does the emperor have new clothes?Intensive care medicine · 2015Article
- Parameter Optimization for Selected Correlation Analysis of Intracranial Pathophysiology.Computational and mathematical methods in medicine · 2015Article
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Authors and funding
5 authors.
Funding
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Abstract
introductionThe status of autoregulation is an important prognostic factor in traumatic brain injury (TBI), and is important to consider in the management of TBI patients. Pressure reactivity index (PRx) is a measure of autoregulation that has been thoroughly studied, but little is known about its variation in different subtypes of TBI. In this study, we examined the impact of PRx and cerebral perfusion pressure (CPP) on outcome in different TBI subtypes.
methods107 patients were retrospectively studied. Data on PRx, CPP, and outcome were collected from our database. The first CT scan was classified according to the Marshall classification system. Patients were assigned to "diffuse" (Marshall class: diffuse-1, diffuse-2, and diffuse-3) or "focal" (Marshall class: diffuse-4, evacuated mass lesion, and non-evacuated mass lesion) groups. 2 × 2 tables were constructed calculating the proportions of favorable/unfavorable outcome at different combinations of PRx and CPP.
resultsLow PRx was significantly associated with favorable outcome in the combined group (p = 0.002) and the diffuse group (p = 0.04), but not in the focal group (p = 0.06). In the focal group higher CPP values were associated with worse outcome (p = 0.02). In diffuse injury patients with disturbed autoregulation (PRx >0.1), CPP >70 mmHg was associated with better outcome (p = 0.03).
conclusionTBI patients with diffuse injury may differ from those with mass lesions. In the latter higher levels of CPP may be harmful, possibly due to BBB disruption. In TBI patients with diffuse injury and disturbed autoregulation higher levels of CPP may be beneficial.
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