AI Article Synopsis

  • * Researchers developed an ultra-low-frequency pressure reactivity index (UL-PRx) using data sampled every 5 minutes to predict 6-month mortality and outcomes in pTBI patients.
  • * Results indicated that a UL-PRx value of 0.30 effectively distinguishes between patients who survive and those who don't, suggesting its potential use in pediatric intensive care to guide treatment decisions in pTBI.

Article Abstract

Purpose: While clinical practice suggests that knowing the cerebral autoregulation (CA) status of traumatic brain injury (TBI) patients is crucial in assessing the best treatment, evidence in pediatric TBI (pTBI) is limited. The pressure reactivity index (PRx) is a surrogate method for the continuous estimation of CA in adults; however, calculations require continuous, high-resolution monitoring data. We evaluate an ultra-low-frequency pressure reactivity index (UL-PRx), based on data sampled at ∼5-min periods, and test its association with 6-month mortality and unfavorable outcome in a cohort of pTBI patients.

Methods: Data derived from pTBI patients (0-18 years) requiring intracranial pressure (ICP) monitoring were retrospectively collected and processed in MATLAB using an in-house algorithm.

Results: Data on 47 pTBI patients were included. UL-PRx mean values, ICP, cerebral perfusion pressure (CPP), and derived indices showed significant association with 6-month mortality and unfavorable outcome. A value of UL-PRx of 0.30 was identified as the threshold to better discriminate both surviving vs deceased patients (AUC: 0.90), and favorable vs unfavorable outcomes (AUC: 0.70) at 6 months. At multivariate analysis, mean UL-PRx and % time with ICP > 20 mmHg, remained significantly associated with 6-month mortality and unfavorable outcome, even when adjusted for International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT)-Core variables. In six patients undergoing secondary decompressive craniectomy, no significant changes in UL-PRx were found after surgery.

Conclusions: UL-PRx is associated with a 6-month outcome even if adjusted for IMPACT-Core. Its application in pediatric intensive care unit could be useful to evaluate CA and offer possible prognostic and therapeutic implications in pTBI patients.

Clinicaltrials: GOV: NCT05043545, September 14, 2021, retrospectively registered.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00701-023-05538-1DOI Listing

Publication Analysis

Top Keywords

pressure reactivity
12
6-month mortality
12
mortality unfavorable
12
unfavorable outcome
12
ultra-low-frequency pressure
8
traumatic brain
8
brain injury
8
association 6-month
8
ptbi patients
8
associated 6-month
8

Similar Publications

Background/objectives: , an anaerobic bacillus ubiquitous in nature, is the leading cause of hospital-acquired diarrhoea and one of the main causes of mortality by nosocomial infections. We aimed to identify the main predictors of the risk of dying and the characteristics of a three-year cohort of patients hospitalised in our clinic that eventually had an unfavourable outcome.

Methods: We collected retrospectively available data for all patients hospitalised between January 1, 2021, and December 31, 2023.

View Article and Find Full Text PDF

Background: The goal of this study was to assess the impact of deep local hyperthermia on oxygen (O) saturation and infected volumes of lungs on coronavirus disease 2019 (COVID-19) cancer patients.

Materials And Methods: Fifty patients who suffered from COVID-19 (according to their computed tomography (CT) images and laboratory findings) were included in this study. The mentioned patients were divided into two groups (I and II) with thirty-five participants.

View Article and Find Full Text PDF

Blockade of PVN neuromedin B receptor alleviates inflammation via the RAS/ROS/NF-κB pathway in spontaneously hypertensive rats.

Brain Res Bull

December 2024

Department of Physiology and Pathophysiology, Xi'an Jiaotong University School of Basic Medical Sciences, Shaanxi Engineering and Research Center of Vaccine, Key Laboratory of Environment and Genes Related to Diseases of Education Ministry of China, Xi'an 710061, China. Electronic address:

Neuromedin B (NMB) has potentially great impacts on the development of cardiovascular diseases by promoting hypertensive and sympatho-excitation effects. However, studies regarding the NMB function in paraventricular nucleus (PVN) are lacking. With selective neuromedin B receptor (NMBR) antagonist, BIM-23127, we aim to determine whether the blockade of NMB function in PVN could alleviate central inflammation and attenuate hypertensive responses.

View Article and Find Full Text PDF

Depression and cardiovascular reactions to acute psychological stress: Is anhedonia the driver?

Int J Psychophysiol

December 2024

Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.

Blunted cardiovascular reactions in response to acute psychological stress are predictive of future health risk. A large body of research has identified depression as an influential factor associated with blunted cardiovascular reactivity. Separately, there has been a resurgence in focus on anhedonia as a key feature of depression, responsible for poor treatment responses to non-improvement in cardiac event-free survival.

View Article and Find Full Text PDF

Incidence and risk factors of heart failure with preserved ejection fraction in elderly patients with hypertension.

BMC Cardiovasc Disord

December 2024

Department of cardiovascular medicine, Chengdu Seventh People's Hospital, No.1188 Shuangxing Avenue, Chengdu city, 610200, Sichuan Province, China.

Background: Heart failure with preserved ejection fraction (HFpEF) poses a significant clinical challenge, especially in older patients with HT. This study aimed to identify the factors influencing HFpEF occurrence in elderly patients with HT.

Methods: Elderly patients with HT were categorized into two groups: no HFpEF group and HFpEF group based on HFpEF diagnosis.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!

A PHP Error was encountered

Severity: Notice

Message: fwrite(): Write of 34 bytes failed with errno=28 No space left on device

Filename: drivers/Session_files_driver.php

Line Number: 272

Backtrace:

A PHP Error was encountered

Severity: Warning

Message: session_write_close(): Failed to write session data using user defined save handler. (session.save_path: /var/lib/php/sessions)

Filename: Unknown

Line Number: 0

Backtrace: