Background Cerebral autoregulation is the process by which cerebral blood flow (CBF) is maintained constant over a specific cerebral perfusion pressure (CPP) range. We have reworked a version of the Ursino and Lodi autoregulation model to derive an index of autoregulation (G), and compared it to a number of other autoregulatory models as well as a gold standard measure of autoregulation obtained from an animal model study (6 piglets with a cranial window preparation and ICP, ABP sampled at 250 Hz). The results of that study have shown that this index G correlates well with the “Bouma” index of autoregulation.
Methods In this study this new autoregulatory index has been calculated for a sample of 12 head injury patient's data over multiple time points and then used to firstly investigate if this index in conjunction with other clinical prognostic factors may give a better indication of outcome and then analyse its trend with time to quantify how the level of autoregulation changes post-injury.
Findings The index correlates well with dichotomised GOSe outcome (p=0.03) and the trend in the result between middle and late time periods shows early signs of being predictive of outcome as well.
Conclusions Though more work is needed these results warrant further investigation with larger numbers of patients
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bouma GJ, Muizelaar JP (1992) Blood pressure and intracranial pressure-volume dynamics in severe head injury relationship with cerebral blood flow. J Neurosurg 77:15–19
R Development Core Team (2007)R:A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org.
Shaw M, Piper IR (2006) Improving comparison of models of pressure autoregulation by adaption of existing models to provide normalised outputs. Proceedings BNRG
Shaw M, Piper IR, Dayley M (2006) Comparison of two models of cerebral pressure autoregulation. J Neurotrauma 23(5):798 May
Ursino M, Lodi CA (1997) A simple mathematical model of the interaction between intracranial pressure and cerebral hemodynamics. J Appl Physiol 82(4):1256–1269 Apr
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 2008 Springer-Verlag/Wien
About this paper
Cite this paper
Shaw, M., Piper, I., Daley, M. (2008). Relationship of a cerebral autoregulatory index with outcome in head injured patients. In: Steiger, H.J. (eds) Acta Neurochirurgica Supplements. Acta Neurochirurgica Supplementum, vol 102. Springer, Vienna. https://doi.org/10.1007/978-3-211-85578-2_7
Download citation
DOI: https://doi.org/10.1007/978-3-211-85578-2_7
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-85577-5
Online ISBN: 978-3-211-85578-2
eBook Packages: MedicineMedicine (R0)