Impact of Chronological Age and Biological Sex on Cerebrovascular Reactivity in Moderate/Severe Traumatic Brain Injury: A CAnadian High-Resolution Traumatic Brain Injury (CAHR-TBI) Study

被引:9
作者
Batson, Carleen [1 ]
Froese, Logan [2 ]
Sekhon, Mypinder [5 ]
Griesdale, Donald [5 ]
Gomez, Alwyn [1 ]
Thelin, Eric P. [6 ,7 ]
Raj, Rahul [8 ,9 ]
Aries, Marcel [10 ,11 ]
Gallagher, Clare [12 ,14 ,15 ]
Bernard, Francis [16 ]
Kramer, Andreas H. [13 ,14 ,15 ]
Zeiler, Frederick A. [1 ,2 ,3 ,4 ,7 ,17 ]
机构
[1] Univ Manitoba, Dept Human Anat & Cell Sci, Winnipeg, MB, Canada
[2] Univ Manitoba, Dept Biomed Engn, Winnipeg, MB, Canada
[3] Univ Manitoba, Dept Surg, Winnipeg, MB, Canada
[4] Univ Manitoba, Ctr Aging, Winnipeg, MB, Canada
[5] Univ British Columbia, Dept Anesthesiol Pharmacol & Therapeut, Vancouver, BC, Canada
[6] Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden
[7] Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden
[8] Univ Helsinki, Dept Neurosurg, Helsinki, Finland
[9] Helsinki Univ Hosp, Helsinki, Finland
[10] Maastricht Univ, Med Ctr, Dept Intens Care, Maastricht, Netherlands
[11] Maastricht Univ, Sch Mental Hlth & Neurosci, Maastricht, Netherlands
[12] Univ Calgary, Dept Clin Neurosci, Calgary, AB, Canada
[13] Univ Calgary, Dept Crit Care Med, Calgary, AB, Canada
[14] Univ Calgary, Dept Clin Neurosci, Calgary, AB, Canada
[15] Univ Calgary, Hotchkiss Brain Inst, Calgary, AB, Canada
[16] Univ Montreal, Dept Med, Montreal, PQ, Canada
[17] Univ Cambridge, Addenbrookes Hosp, Dept Med, Cambridge, England
基金
加拿大自然科学与工程研究理事会;
关键词
age; biological sex; cerebrovascular reactivity; PAx; PRx; RAC; NEUROTRAUMA EFFECTIVENESS RESEARCH; CEREBRAL PERFUSION-PRESSURE; INTRACRANIAL-PRESSURE; PULSE AMPLITUDE; TIME BURDEN; HEAD-INJURY; LOWER LIMIT; PART II; AUTOREGULATION; INDEXES;
D O I
10.1089/neu.2022.0293
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Impaired cerebrovascular reactivity has emerged as an important associate with poor long-term outcome after moderate/severe traumatic brain injury (TBI). However, our understanding of what drives or modulates the degree of impaired cerebrovascular function remains poor. Age and biological sex remain important modifiers of cerebrovascular function in health and disease, yet their impact on cerebrovascular reactivity after TBI remains unclear. The aim of this study was to explore subgroup responses based on age and biological sex on cerebral physiology. Data from 283 TBI patients from the CAnadian High Resolution TBI (CAHR-TBI) Research Collaborative were evaluated. Cerebrovascular reactivity was determined using highfrequency cerebral physiology for the derivation of three intracranial pressure (ICP)-based indices: 1) pressure reactivity index (PRx)-correlation between ICP and mean arterial pressure ( MAP); 2) pulse amplitude index (PAx)-correlation between pulse amplitude of ICP (AMP) and MAP; and 3) RAC-correlation between AMP and cerebral perfusion pressure (CPP). Insult burden (% time above clinically defined thresholds) were calculated for these indices. These cerebral physiology indices were studied for their relationship with age via linear regression, age trichotomization (< 40, 40 - 60, > 60), and decades of age (< 30, 30-39, 40-49, 50-59, 60-69, > 69) schemes. Similarly, differences based on biological sex were assessed. A statistically significant positive linear correlation was found between PAx, RAC, and age. In corollary, a statistically significant relationship was found between increasing age on trichotomized and decades of age analysis with PAx and RAC measures. PRx failed to demonstrate such relationships to advancing age. There was
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收藏
页码:1098 / 1111
页数:14
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