Clinical study of continuous non-invasive cerebrovascular autoregulation monitoring in neurosurgical ICU

Acta Neurochir Suppl. 2005:95:367-70. doi: 10.1007/3-211-32318-x_75.

Abstract

Ultrasonic "time-of-flight" monitor (Vittamed) was used for continuous monitoring of intracranial blood volume (IBV) pulse, respiratory, slow waves and cerebrovascular autoregulation (CA). The objectives are to compare of invasively and non-invasively monitored slow intracranial waves and CA of ICU patients and to evaluate the phase shift between ABP and IBV respiratory waves as a possible estimator of CA. CA monitoring has been performed in 13 patients with severe TBI (age mean/range 30.5/(18-64)). Data were collected from 87 one-hour sessions of simultaneous invasive and non-invasive wave monitoring and from 53 one-hour sessions of invasive and non-invasive CA monitoring. High correlation (R > 0.9) has been obtained between invasively and non-invasively recorded intracranial slow waves. Bland Altman difference between invasively and non-invasively recorded intracranial slow waves is clinically not significant (mean =-0.07, SD = 0.089, alpha = 0.05). Agreement has been confirmed between invasive and non-invasive CA monitoring data in a wide range of R = [-0.85; +0.96]. Hypothesis of the coincidence of invasive and non-invasive CA assessment is accepted (p < 0.05). Phase shift monitoring of permanent respiratory ABP waves and IBV waves permit continuous non-invasive CA estimation without unnatural physical or pharmacological stimulations of CA system.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Blood Pressure
  • Brain / blood supply
  • Cerebrovascular Circulation*
  • Craniocerebral Trauma / diagnostic imaging*
  • Critical Care / methods*
  • Echoencephalography / methods*
  • Hemostasis
  • Humans
  • Image Interpretation, Computer-Assisted / methods*
  • Intracranial Pressure
  • Monitoring, Physiologic / methods*
  • Neurosurgery / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity