ArticleJournal of clinical monitoring and computing2023
Towards autoregulation-oriented management after traumatic brain injury: increasing the reliability and stability of the CPPopt algorithm.
Article in Journal of clinical monitoring and computing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
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Who cites it
40 citing papers in PubMed.
- Does Targeting CPP at CPPopt Actually Improve Cerebrovascular Reactivity? A Secondary Analysis of the COGiTATE Randomized Controlled Trial.Neurocritical care · 2025Trial
- Stable tissue oxygen cerebral perfusion pressure (stoCPP): Proof of concept for a novel method for the assessment of optimum cerebral perfusion pressure in severe traumatic brain injury.Journal of clinical monitoring and computing · 2026Article
- Toward comprehensive multimodal neuromonitoring of surrogates of cerebral autoregulation in traumatic brain injury: insights from a hyperventilation protocol.Neurophotonics · 2026Article
- Non-invasive cerebral oxygenation and blood pressure neuromonitoring characterizes dynamic cerebrovascular autoregulation following cardiac arrest.Resuscitation plus · 2026Article
- Proteomic blood-based biomarkers of brain damage in traumatic brain injury: are they suitable surrogate endpoints for cerebral pressure autoregulatory-guided therapy?Critical care (London, England) · 2026Observational
- Impact of positive end-expiratory pressure on autonomic nervous system activity and its interaction with cerebrovascular reactivity - an experimental study.Journal of clinical monitoring and computing · 2026Article
- Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices.Journal of stroke · 2026Review
- A novel algorithm for the continuous determination of individualized intracranial pressure (iICP) thresholds using a multi-window weighted approach.BMC medical informatics and decision making · 2026Article
- A noninvasive method for assessing optimal cerebral perfusion pressure.Critical care (London, England) · 2026Observational
- Autoregulation-Guided Blood Pressure Targets After Stroke Thrombectomy: Impact on Secondary Brain Injury and Neurologic Outcomes.Neurology · 2026Observational
- Exploring the Upper Limits of Cerebral Perfusion Pressure in Pediatric Traumatic Brain Injury: A STARSHIP Analysis.Neurocritical care · 2026Observational
- Multimodal Monitoring in Eclamptic Intracerebral Hemorrhage Complicated by Reversible Cerebral Vasoconstriction Syndrome (RCVS): A Case Report.Case reports in critical care · 2026Article
- Intercerebral autoregulation index consistency in the derivation of CPPopt, MAPopt, and BISopt in humans: A scoping review.Physiological reports · 2025Article
- The lower limit margin: a determinant of autoregulatory sensitivity to changes in cerebral perfusion pressure.Critical care (London, England) · 2025Article
- Artifact management methodologies for arterial blood pressure signals: A systematic scoping review of human and animal literature.Physiological reports · 2025Article
- A Comprehensive Review of Fluid Resuscitation Strategies in Traumatic Brain Injury.Journal of clinical medicine · 2025Review
- Visualizations of autoregulatory insults in moderate-to-severe paediatric traumatic brain injury: a secondary analysis from the multicentre STARSHIP trial.Critical care (London, England) · 2025Article
- Dynamic versus fixed cerebral perfusion pressure targets in paediatric traumatic brain injury: a STARSHIP analysis.EClinicalMedicine · 2025Article
- Reconsidering the symmetric assumption in CPP-PRx modeling for traumatic brain injury.Critical care (London, England) · 2025Article
- Monro-Kellie 4.0: moving from intracranial pressure to intracranial dynamics.Critical care (London, England) · 2025Review
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Authors and funding
9 authors.
Funding
Abstract
purposeCPPopt denotes a Cerebral Perfusion Pressure (CPP) value at which the Pressure-Reactivity index, reflecting the global state of Cerebral Autoregulation, is best preserved. CPPopt has been investigated as a potential dynamically individualised CPP target in traumatic brain injury patients admitted in intensive care unit. The prospective bedside use of the concept requires ensured safety and reliability of the CPP recommended targets based on the automatically-generated CPPopt. We aimed to: Increase stability and reliability of the CPPopt automated algorithm by fine-tuning; perform outcome validation of the adjusted algorithm in a multi-centre TBI cohort.
methodsICM + software was used to derive CPPopt and fine-tune the algorithm. Parameters for improvement of the algorithm were selected based on qualitative and quantitative assessment of stability and reliability metrics. Patients enrolled in the Collaborative European Neuro Trauma Effectiveness Research in TBI (CENTER-TBI) high-resolution cohort were included for retrospective validation. Yield and stability of the new algorithm were compared to the previous algorithm using Mann-U test. Area under the curves for mortality prediction at 6 months were compared with the DeLong Test.
resultsCPPopt showed higher stability (p < 0.0001), but lower yield compared to the previous algorithm [80.5% (70-87.5) vs 85% (75.7-91.2), p < 0.001]. Deviation of CPPopt could predict mortality with an AUC of [AUC = 0.69 (95% CI 0.59-0.78), p < 0.001] and was comparable with the previous algorithm.
conclusionThe CPPopt calculation algorithm was fine-tuned and adapted for prospective use with acceptable lower yield, improved stability and maintained prognostic power.
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