共 34 条
Blood Pressure Variability and Optimal Cerebral Perfusion Pressure-New Therapeutic Targets in Traumatic Brain Injury
被引:33
作者:

Wettervik, Teodor Svedung
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden

Howells, Timothy
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden

Lewen, Anders
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden

Enblad, Per
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden
机构:
[1] Uppsala Univ, Dept Neurosci, Sect Neurosurg, S-75185 Uppsala, Sweden
关键词:
Autoregulation;
Blood pressure variability;
CPPopt;
Traumatic brain injury;
HEART-RATE-VARIABILITY;
REACTIVITY;
MANAGEMENT;
GUIDELINES;
D O I:
10.1093/neuros/nyz515
中图分类号:
R74 [神经病学与精神病学];
学科分类号:
摘要:
BACKGROUND: Optimal cerebral perfusion pressure (CPPopt) is an autoregulatory-oriented target in the neurointensive care (NIC) of patients with traumatic brain injury (TBI), and deviation from CPPopt is associated with poor outcome. We recently found that blood pressure variability (BPV) is associated with deviation from CPPopt. OBJECTIVE: To evaluate BPV and other variables related to deviation from CPPopt and to evaluate challenges and strategies for autoregulatory-oriented treatment in TBI. METHODS: Data including arterial blood pressure and intracranial pressure (ICP) from 362 TBI patients treated at the NIC unit, Uppsala University Hospital, Sweden, between 2008 and 2016, were retrospectively analyzed day 2 to 5. RESULTS: Higher BPV was a strong predictor of both CPP deviation below and above CPPopt after multiple regression analyses. There was no other explanatory variable for CPP deviation above CPPopt, whereas also higher ICP and worse autoregulation (higher pressure reactivity index) were associated with CPP deviation below CPPopt. A higher BPV was, in turn, explained by older age, lower ICP, higher mean arterial blood pressure, and higher slow arterial blood pressure amplitude (0.018-0.067 Hz). CONCLUSION: BPV was strongly associated with deviation from CPPopt. High age is a risk factor for high BPV and hence CPP insults. Our treatment protocol is focused on avoiding CPP below 60 mm Hg. It is possible that a more restrictive upper level could generate more stable blood pressure and less deviation from CPPopt.
引用
收藏
页码:E300 / E309
页数:10
相关论文
共 34 条
[21]
Relationship Between Short-Term Blood Pressure Variability and Large-Artery Stiffness in Human Hypertension Findings From 2 Large Databases
[J].
Schillaci, Giuseppe
;
Bilo, Grzegorz
;
Pucci, Giacomo
;
Laurent, Stephane
;
Macquin-Mavier, Isabelle
;
Boutouyrie, Pierre
;
Battista, Francesca
;
Settimi, Laura
;
Desamericq, Gaelle
;
Dolbeau, Guillaume
;
Faini, Andrea
;
Salvi, Paolo
;
Mannarino, Elmo
;
Parati, Gianfranco
.
HYPERTENSION,
2012, 60 (02)
:369-+

Schillaci, Giuseppe
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Perugia, Dipartimento Med Clin & Sperimentale, I-06100 Perugia, Italy
Osped S Maria, Terni, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Bilo, Grzegorz
论文数: 0 引用数: 0
h-index: 0
机构:
S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Pucci, Giacomo
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Perugia, Dipartimento Med Clin & Sperimentale, I-06100 Perugia, Italy
Univ Milano Bicocca, Dept Clin Med & Prevent, I-20149 Milan, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

论文数: 引用数:
h-index:
机构:

Macquin-Mavier, Isabelle
论文数: 0 引用数: 0
h-index: 0
机构:
Hop H Mondor A Chenevier, AP HP, Serv Pharmacol Clin, Creteil, France
Univ Paris Est, Fac Med, Creteil, France S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Boutouyrie, Pierre
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Paris 05, Paris, France
Hop Georges Pompidou, AP HP, Paris, France
INSERM, U970, Paris, France S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Battista, Francesca
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Perugia, Dipartimento Med Clin & Sperimentale, I-06100 Perugia, Italy
Osped S Maria, Terni, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Settimi, Laura
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Perugia, Dipartimento Med Clin & Sperimentale, I-06100 Perugia, Italy
Osped S Maria Misericordia, Perugia, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Desamericq, Gaelle
论文数: 0 引用数: 0
h-index: 0
机构:
Hop H Mondor A Chenevier, AP HP, Serv Pharmacol Clin, Creteil, France
Univ Paris Est, Fac Med, Creteil, France S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Dolbeau, Guillaume
论文数: 0 引用数: 0
h-index: 0
机构:
Hop H Mondor A Chenevier, AP HP, Unite Rech Clin, Creteil, France
Univ Paris Est, Fac Med, Creteil, France
INSERM, U955, Equipe 1, Creteil, France S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Faini, Andrea
论文数: 0 引用数: 0
h-index: 0
机构:
S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Salvi, Paolo
论文数: 0 引用数: 0
h-index: 0
机构:
S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Mannarino, Elmo
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Perugia, Dipartimento Med Clin & Sperimentale, I-06100 Perugia, Italy
Osped S Maria Misericordia, Perugia, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy

Parati, Gianfranco
论文数: 0 引用数: 0
h-index: 0
机构:
S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy
Osped S Maria, Terni, Italy S Luca Hosp, Ist Auxol Italiano, Dept Cardiol, I-20149 Milan, Italy
[22]
Identification of blood pressure control mechanisms by power spectral analysis
[J].
Stauss, Harald M.
.
CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY,
2007, 34 (04)
:362-368

Stauss, Harald M.
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Iowa, Dept Integrat Physiol, Iowa City, IA 52242 USA Univ Iowa, Dept Integrat Physiol, Iowa City, IA 52242 USA
[23]
Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury
[J].
Steiner, LA
;
Czosnyka, M
;
Piechnik, SK
;
Smielewski, P
;
Chatfield, D
;
Menon, DK
;
Pickard, JD
.
CRITICAL CARE MEDICINE,
2002, 30 (04)
:733-738

Steiner, LA
论文数: 0 引用数: 0
h-index: 0
机构: Univ Cambridge, Addenbrookes Hosp, Dept Anaesthesia, Cambridge CB2 2QQ, England

Czosnyka, M
论文数: 0 引用数: 0
h-index: 0
机构: Univ Cambridge, Addenbrookes Hosp, Dept Anaesthesia, Cambridge CB2 2QQ, England

Piechnik, SK
论文数: 0 引用数: 0
h-index: 0
机构: Univ Cambridge, Addenbrookes Hosp, Dept Anaesthesia, Cambridge CB2 2QQ, England

论文数: 引用数:
h-index:
机构:

Chatfield, D
论文数: 0 引用数: 0
h-index: 0
机构: Univ Cambridge, Addenbrookes Hosp, Dept Anaesthesia, Cambridge CB2 2QQ, England

Menon, DK
论文数: 0 引用数: 0
h-index: 0
机构: Univ Cambridge, Addenbrookes Hosp, Dept Anaesthesia, Cambridge CB2 2QQ, England

Pickard, JD
论文数: 0 引用数: 0
h-index: 0
机构: Univ Cambridge, Addenbrookes Hosp, Dept Anaesthesia, Cambridge CB2 2QQ, England
[24]
Impaired baroreflex sensitivity predicts outcome of acute intracerebral hemorrhage
[J].
Sykora, Marek
;
Diedler, Jennifer
;
Rupp, Andre
;
Turcani, Peter
;
Rocco, Andrea
;
Steiner, Thorsten
.
CRITICAL CARE MEDICINE,
2008, 36 (11)
:3074-3079

Sykora, Marek
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, Heidelberg, Germany
Comenius Univ, Dept Neurol, Bratislava, Slovakia Heidelberg Univ, Dept Neurol, Heidelberg, Germany

Diedler, Jennifer
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, Heidelberg, Germany Heidelberg Univ, Dept Neurol, Heidelberg, Germany

Rupp, Andre
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, Heidelberg, Germany Heidelberg Univ, Dept Neurol, Heidelberg, Germany

Turcani, Peter
论文数: 0 引用数: 0
h-index: 0
机构:
Comenius Univ, Dept Neurol, Bratislava, Slovakia Heidelberg Univ, Dept Neurol, Heidelberg, Germany

Rocco, Andrea
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, Heidelberg, Germany Heidelberg Univ, Dept Neurol, Heidelberg, Germany

Steiner, Thorsten
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, Heidelberg, Germany Heidelberg Univ, Dept Neurol, Heidelberg, Germany
[25]
Autonomic Impairment in Severe Traumatic Brain Injury: A Multimodal Neuromonitoring Study
[J].
Sykora, Marek
;
Czosnyka, Marek
;
Liu, Xiuyun
;
Donnelly, Joseph
;
Nasr, Nathalie
;
Diedler, Jennifer
;
Okoroafor, Francois
;
Hutchinson, Peter
;
Menon, David
;
Smielewski, Peter
.
CRITICAL CARE MEDICINE,
2016, 44 (06)
:1173-1181

Sykora, Marek
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England
Heidelberg Univ, Dept Neurol, Heidelberg, Germany Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

论文数: 引用数:
h-index:
机构:

Liu, Xiuyun
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

Donnelly, Joseph
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

Nasr, Nathalie
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England
CHU Toulouse, Dept Neurol, Unite Neurol Vasc, Toulouse, France
Univ Toulouse 3, INSERM U1048, I2MC Toulouse, Team 11, F-31062 Toulouse, France Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

Diedler, Jennifer
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Tubingen, Dept Neurol & Neurosurg, Tubingen, Germany Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

Okoroafor, Francois
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

Hutchinson, Peter
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

Menon, David
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Cambridge, Dept Anaesthesiol, Cambridge, England Univ Cambridge, Dept Clin Neurosci, Div Neurosurg, Cambridge, England

论文数: 引用数:
h-index:
机构:
[26]
Baroreflex: A New Therapeutic Target in Human Stroke?
[J].
Sykora, Marek
;
Diedler, Jennifer
;
Turcani, Peter
;
Hacke, Werner
;
Steiner, Thorsten
.
STROKE,
2009, 40 (12)
:E678-E682

Sykora, Marek
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany
Comenius Univ, Dept Neurol, Bratislava, Slovakia Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Diedler, Jennifer
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Turcani, Peter
论文数: 0 引用数: 0
h-index: 0
机构:
Comenius Univ, Dept Neurol, Bratislava, Slovakia Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Hacke, Werner
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Steiner, Thorsten
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany
[27]
Subacute perihematomal edema in intracerebral hemorrhage is associated with impaired blood pressure regulation
[J].
Sykora, Marek
;
Diedler, Jennifer
;
Turcani, Peter
;
Rupp, Andre
;
Steiner, Thorsten
.
JOURNAL OF THE NEUROLOGICAL SCIENCES,
2009, 284 (1-2)
:108-112

Sykora, Marek
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany
Comenius Univ, Dept Neurol, Bratislava 81369, Slovakia Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Diedler, Jennifer
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Turcani, Peter
论文数: 0 引用数: 0
h-index: 0
机构:
Comenius Univ, Dept Neurol, Bratislava 81369, Slovakia Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Rupp, Andre
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany

Steiner, Thorsten
论文数: 0 引用数: 0
h-index: 0
机构:
Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany Heidelberg Univ, Dept Neurol, D-69120 Heidelberg, Germany
[28]
Analyzing outcome of treatment of severe head injury: A review and update on advancing the use of the Glasgow Outcome Scale
[J].
Teasdale, GM
;
Pettigrew, LEL
;
Wilson, JTL
;
Murray, G
;
Jennett, B
.
JOURNAL OF NEUROTRAUMA,
1998, 15 (08)
:587-597

Teasdale, GM
论文数: 0 引用数: 0
h-index: 0
机构: Univ Glasgow, Dept Neurosurg, Glasgow, Lanark, Scotland

Pettigrew, LEL
论文数: 0 引用数: 0
h-index: 0
机构: Univ Glasgow, Dept Neurosurg, Glasgow, Lanark, Scotland

Wilson, JTL
论文数: 0 引用数: 0
h-index: 0
机构: Univ Glasgow, Dept Neurosurg, Glasgow, Lanark, Scotland

论文数: 引用数:
h-index:
机构:

Jennett, B
论文数: 0 引用数: 0
h-index: 0
机构: Univ Glasgow, Dept Neurosurg, Glasgow, Lanark, Scotland
[29]
Measurement of pulse wave velocity: site matters
[J].
Tillin, Therese
;
Chambers, John
;
Malik, Iqbal
;
Coady, Emma
;
Byrd, Sheila
;
Mayet, Jamil
;
Wright, Andrew R.
;
Kooner, Jaspal
;
Shore, Angela
;
Thom, Simon
;
Chaturvedi, Nish
;
Hughes, Alun
.
JOURNAL OF HYPERTENSION,
2007, 25 (02)
:383-389

Tillin, Therese
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Chambers, John
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Malik, Iqbal
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Coady, Emma
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Byrd, Sheila
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Mayet, Jamil
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Wright, Andrew R.
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Kooner, Jaspal
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Shore, Angela
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Thom, Simon
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Chaturvedi, Nish
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England

Hughes, Alun
论文数: 0 引用数: 0
h-index: 0
机构: St Marys Hosp, Hammersmith Hosp & Imperial Coll, Int Ctr Circulatory Hlth, London, England
[30]
Temporal Neurophysiological Dynamics in Traumatic Brain Injury: Role of Pressure Reactivity and Optimal Cerebral Perfusion Pressure for Predicting Outcome
[J].
Wettervik, Teodor Svedung
;
Howells, Timothy
;
Enblad, Per
;
Lewen, Anders
.
JOURNAL OF NEUROTRAUMA,
2019, 36 (11)
:1818-1827

Wettervik, Teodor Svedung
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden

Howells, Timothy
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden

Enblad, Per
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden

Lewen, Anders
论文数: 0 引用数: 0
h-index: 0
机构:
Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden Uppsala Univ, Uppsala Univ Hosp, Dept Neurosci, Sect Neurosurg, Uppsala, Sweden