The lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury: a CENTER-TBI high-resolution sub-study analysis

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dc.contributor.authorBeqiri, Erta
dc.contributor.authorZeiler, Frederick A.
dc.contributor.authorErcole, Ari
dc.contributor.authorPlacek, Michal M.
dc.contributor.authorTas, Jeanette
dc.contributor.authorDonnelly, Joseph
dc.contributor.authorAries, Marcel J. H.
dc.contributor.authorHutchinson, Peter J.
dc.contributor.authorMenon, David
dc.contributor.authorStocchetti, Nino
dc.contributor.authorCzosnyka, Marek
dc.contributor.authorSmielewski, Peter
dc.date.accessioned2023-06-01T17:25:54Z
dc.date.available2023-06-01T17:25:54Z
dc.date.issued2023-05-20
dc.date.updated2023-06-01T03:27:57Z
dc.description.abstractAbstract Background A previous retrospective single-centre study suggested that the percentage of time spent with cerebral perfusion pressure (CPP) below the individual lower limit of reactivity (LLR) is associated with mortality in traumatic brain injury (TBI) patients. We aim to validate this in a large multicentre cohort. Methods Recordings from 171 TBI patients from the high-resolution cohort of the CENTER-TBI study were processed with ICM+ software. We derived LLR as a time trend of CPP at a level for which the pressure reactivity index (PRx) indicates impaired cerebrovascular reactivity with low CPP. The relationship with mortality was assessed with Mann-U test (first 7-day period), Kruskal–Wallis (daily analysis for 7 days), univariate and multivariate logistic regression models. AUCs (CI 95%) were calculated and compared using DeLong’s test. Results Average LLR over the first 7 days was above 60 mmHg in 48% of patients. %time with CPP < LLR could predict mortality (AUC 0.73, p =  < 0.001). This association becomes significant starting from the third day post injury. The relationship was maintained when correcting for IMPACT covariates or for high ICP. Conclusions Using a multicentre cohort, we confirmed that CPP below LLR was associated with mortality during the first seven days post injury.en_US
dc.identifier.citationCritical Care. 2023 May 20;27(1):194
dc.identifier.citationCritical Care. 2023 May 20;27(1):194
dc.identifier.citationCritical Care. 2023 May 20;27(1):194
dc.identifier.citationCritical Care. 2023 May 20;27(1):194
dc.identifier.citationCritical Care. 2023 May 20;27(1):194
dc.identifier.citationCritical Care. 2023 May 20;27(1):194
dc.identifier.doi10.1186/s13054-023-04485-8
dc.identifier.urihttp://hdl.handle.net/1993/37363
dc.language.isoengen_US
dc.language.rfc3066en
dc.publisherBioMed Central (BMC)en_US
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.titleThe lower limit of reactivity as a potential individualised cerebral perfusion pressure target in traumatic brain injury: a CENTER-TBI high-resolution sub-study analysisen_US
dc.typejournal articleen_US
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Surgeryen_US
oaire.citation.issue1en_US
oaire.citation.startPage194en_US
oaire.citation.titleCritical Careen_US
oaire.citation.volume27en_US
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