ArticleNeurocritical care2025
Noninvasive Method Using Mechanical Extensometer for the Estimation of Intracranial Compliance by Repeated Measures Agreement Analysis.
Article in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Intracranial Pressure Estimation Using B4C Device: A Systematic Review on the Validation Studies.Neurocritical care · 2026Review
- Practicalities of noninvasive neuromonitoring in intensive care.Neurocritical care · 2026Article
- Non-invasive intracranial pressure estimation in the intensive care unit: narrative review of methods and clinical applications.Intensive care medicine · 2026Review
- A noninvasive method for assessing optimal cerebral perfusion pressure.Critical care (London, England) · 2026Observational
- Impact of hemodynamic management guided by intracranial compliance on the outcome of critically ill patients - preliminary results and exploratory economic evaluation.Cost effectiveness and resource allocation : C/E · 2026Article
- Systematic review of the diagnostic accuracy of noninvasive intracranial pressure monitoring using optic nerve sheath diameter and the Brain4Care system.Brain & spine · 2026Review
- The clinical significance of intracranial pressure waveform analysis in brain-injured patients.Critical care science · 2026Review
- Exploring Cerebrospinal Compensatory Zones Using a Noninvasive Approach.Neurocritical care · 2025Observational
- Shunt Dysfunction Assessment in Shunted Patients via Multiparametric Non-Invasive ICP Waveform Monitoring.Biomedicines · 2025Article
- Clinical Performance of the Brain4care System for Noninvasive Detection of Intracranial Hypertension.Neurocritical care · 2025Article
- Monro-Kellie 4.0: moving from intracranial pressure to intracranial dynamics.Critical care (London, England) · 2025Review
- The dawn of noninvasive intracranial compliance waveforms: a call for the B-ICONIC improvement and expansion.Intensive care medicine · 2025Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIntracranial compliance refers to the relationship between changes in volume and the resultant changes in intracranial pressure (ICP). This study aimed to assess the agreement of a noninvasive ICP waveform device for the estimation of compliance compared with invasive ICP monitoring employing three distinct methods.
methodsWe conducted a retrospective analysis of ICP waveform morphology recorded through both invasive (external ventricular drain) and noninvasive (mechanical extensometer) methods in adult patients with acute brain injury admitted to a neurointensive care unit between August 2021 and August 2022. Compliance was calculated as the amplitude of the fundamental component of cerebral arterial blood volume (estimated with concurrent Transcranial Doppler [TCD] recordings), divided by the amplitude of the fundamental component of the invasive and noninvasive ICP waveforms. Subsequently, we assessed the agreement between invasive and noninvasive intracranial compliance by repeated measures correlation coefficient analysis using three methods: TCD-derived, P2/P1 ratio, and time-to-peak (TTP). A linear mixed-effects model was used to compute the concordance correlation coefficient, total deviation index, and coefficient of individual agreement. Coverage probability plot was calculated to estimate the percent of observations within different cut points for each of the three methods.
resultsA total of 21 patients were identified for this study. Repeated measures correlation analysis showed a strong correlation (R = 0.982, 95% confidence interval [0.980-0.984], p < 0.0001) between log-transformed noninvasive and invasive compliance. Agreement statistics for TCD, P2/P1 ratio, and TTP indicated that although the concordance correlation coefficient was highest for log(TCD) values, TTP and P2:P1 ratio measures had better agreement with total deviation index and coverage probability plot analyses.
conclusionsRepeated measures correlations suggest that ICP waveform analyses may offer a more accurate estimate of compliance than TCD-derived methods for noninvasive ICP monitoring. Further validations studies are warranted to confidently establish this method as an indicator of intracranial compliance.
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