Assessment of non-invasive ICP during CSF infusion test: an approach with Transcranial Doppler
MetadataShow full item record
Cardim, D., Czosnyka, M., Donnelly, J., Robba, C., Cabella, B., Liu, X., Cabeleira, M., et al. (2015). Assessment of non-invasive ICP during CSF infusion test: an approach with Transcranial Doppler. Acta Neurochirurgica, 158 279-287. https://doi.org/10.1007/s00701-015-2661-8
Objectives. This study aimed to compare four non-invasive intracranial pressure (nICP) methods in a prospective cohort of hydrocephalus patients whose CSF dynamics was investigated using infusion tests involving controllable test-rise of ICP. Material & Methods. Cerebral blood flow velocity (FV), ICP and non-invasive arterial blood pressure (ABP) were recorded in 53 patients diagnosed for hydrocephalus. nICP methods were based on: I) interaction between FV and ABP using black-box model (nICP_BB); II) diastolic FV (nICP_FVd); III) critical closing pressure (nICP_CrCP) and IV) TCD-derived pulsatility index (nICP_PI). Correlation between rise in ICP (∆ICP) and ∆nICP and averaged correlations for changes in time between ICP and nICP during infusion test were investigated. Results. All nICP formulas overestimated ICP at. At plateau of ICP during infusion test, only nICP_BB and nICP_PI presented significant difference from ICP. From baseline to plateau, all nICPs estimators increased significantly. Correlations between ∆ICP and ∆nICP were better represented by nICP_PI and nICP_BB: 0.45 and 0.30 (p<0.05). nICP_FVd and nICP_CrCP presented non-significant correlations: -0.17 (p=0.21), 0.21 (p=0.13). For changes in ICP during individual infusion test nICP_PI, nICP_BB and nICP_FVd presented similar correlations with ICP: 0.39±0.40, 0.39±0.43 and 0.35±0.41 respectively. nICP_CrCP presented a weaker correlation (R=0.29±0.24). Conclusions. Out of the 4 methods, nICP_PI was the one with best performance for predicting changes in ∆ICP during infusion test, followed by nICP_BB. nICP_FVd and nICP_CrCP showed unreliable correlations. Changes of ICP observed during the test were expressed by nICP values with only moderate correlations.
non-invasive ICP monitoring, Transcranial Doppler, cerebral blood flow velocity, CSF Infusion test
DC is supported by a Cambridge Commonwealth, European & International Trust Scholarship, University of Cambridge. JD is supported by a Woolf Fisher Trust Scholarship. XL is supported by a Gates Cambridge Trust Scholarship. BCTC is supported by CNPQ (Research Project 203792/2014-9). DC and MC are partially supported by NIHR Brain Injury Healthcare Technology Co-operative, Cambridge, UK.
External DOI: https://doi.org/10.1007/s00701-015-2661-8
This record's URL: https://www.repository.cam.ac.uk/handle/1810/253067
Creative Commons Attribution 4.0 International License
Licence URL: http://creativecommons.org/licenses/by/4.0/