Occurrence of CPPopt values in uncorrelated ICP and ABP time series
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Abstract
Optimal CPP (CPPopt) is a concept that uses PRx - CPP relationship over a given time period to find a value of CPP at which PRx shows best autoregulation. . It has been proposed that this relationship can be modelled by a U-shaped curve, where the minimum is interpreted as being the CPP value which corresponds to the strongest autoregulation. Due to the nature of the calculation and the signals involved in it, the occurrence of false positives is possible. Such random occurrences would artificially increase the yield of CPPopt values and decrease the reliability of the methodology. In this work we study the probability of the random occurrence of false positives and we will compare the effect of the parameters used for CPPopt calculation on this probability. The percentage of CPPopt curves generated from uncorrelated data was demonstrated to be 11.5%. This value can be minimized by tuning some of the calculation parameters such as increasing the calculation window and increasing the minimum PRx span accepted on the curve. Keywords: Optimal CPP, Pressure reactivity, PRx, ICM+, Brain trauma, Brain monitoring, Neuro-critical care