Observational studyJournal of clinical monitoring and computing2024
The Optimal pressure reactivity index range is disease-specific: A comparison between aneurysmal subarachnoid hemorrhage and traumatic brain injury.
Observational study in Journal of clinical monitoring and computing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Invasive Monitoring of Cerebral Autoregulation in Aneurysmal Subarachnoid and Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Intracranial compliance monitoring using pulse shape index in traumatic brain injury: relation to cerebral physiology and clinical outcome.Critical care (London, England) · 2026Article
- Temporal Dynamics of Cerebral Autoregulation after Aneurysmal Subarachnoid Hemorrhage: Insights from Pressure Reactivity Index and Non-injured Controls.Neurology and therapy · 2026Article
- Intracranial pressure management in severe intraventricular hemorrhage: A minireview.World journal of critical care medicine · 2026Review
- Intracranial pressure dynamics, cerebral autoregulation, and brain perfusion after decompressive craniectomy in malignant middle cerebral artery infarction: is there a role for invasive monitoring?Acta neurochirurgica · 2025Article
- Autoregulatory-guided management in traumatic brain injury: does age matter?Acta neurochirurgica · 2025Observational
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Abstract
purposeImpaired cerebral pressure autoregulation is common and detrimental after acute brain injuries. Based on the prevalence of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage (aSAH) patients compared to traumatic brain injury (TBI), we hypothesized that the type of autoregulatory disturbance and the optimal PRx range may differ between these two conditions. The aim of this study was to determine the optimal PRx ranges in relation to functional outcome following aSAH and TBI, respectively.
methodsIn this observational study, 487 aSAH patients and 413 TBI patients, treated in the neurointensive care, Uppsala, Sweden, between 2008 and 2018, were included. The percentage of good monitoring time (%GMT) of PRx was calculated within 8 intervals covering the range from -1.0 to + 1.0, and analyzed in relation to favorable outcome (GOS-E 5 to 8).
resultsIn multiple logistic regressions, a higher %GMTs of PRx in the intervals -1.0 to -0.5 and + 0.75 to + 1.0 were independently associated with a lower rate of favorable outcome in the aSAH cohort. In a similar analysis in the TBI cohort, only positive PRx in the interval + 0.75 to + 1.0 was independently associated with a lower rate of favorable outcome.
conclusionExtreme PRx values in both directions were unfavorable in aSAH, possibly as high PRx could indicate proximal vasospasm with exhausted distal vasodilatory reserve, while very negative PRx could reflect myogenic hyperreactivity with suppressed cerebral blood flow. Only elevated PRx was unfavorable in TBI, possibly as pressure passive vessels may be a more predominant pathomechanism in this disease.
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