Repository logo
 

Non-Invasive Pressure Reactivity Index Using Doppler Systolic Flow Parameters: A Pilot Analysis.

cam.issuedOnline2018-09-27
dc.contributor.authorZeiler, Frederick A
dc.contributor.authorSmielewski, Peter
dc.contributor.authorStevens, Andrew
dc.contributor.authorCzosnyka, Marek
dc.contributor.authorMenon, David K
dc.contributor.authorErcole, Ari
dc.contributor.orcidZeiler, Frederick [0000-0003-1737-0510]
dc.contributor.orcidSmielewski, Peter [0000-0001-5096-3938]
dc.contributor.orcidCzosnyka, Marek [0000-0003-2446-8006]
dc.contributor.orcidMenon, David [0000-0002-3228-9692]
dc.contributor.orcidErcole, Ari [0000-0001-8350-8093]
dc.date.accessioned2018-10-03T04:44:26Z
dc.date.available2018-10-03T04:44:26Z
dc.date.issued2019-03-01
dc.description.abstractThe goal was to predict pressure reactivity index (PRx) using non-invasive transcranial Doppler (TCD) based indices of cerebrovascular reactivity, systolic flow index (Sx_a), and mean flow index (Mx_a). Continuous extended duration time series recordings of middle cerebral artery cerebral blood flow velocity (CBFV) were obtained using robotic TCD in parallel with direct intracranial pressure (ICP). PRx, Sx_a, and Mx_a were derived from high frequency archived signals. Using time-series techniques, autoregressive integrative moving average (ARIMA) structure of PRx was determined and embedded in the following linear mixed effects (LME) models of PRx: PRx ∼ Sx_a and PRx ∼ Sx_a + Mx_a. Using 80% of the recorded patient data, the LME models were created and trained. Model superiority was assessed via Akaike information criterion (AIC), Bayesian information criterion (BIC), and log-likelihood (LL). The superior two models were then used to predict PRx using the remaining 20% of the signal data. Predicted and observed PRx were compared via Pearson correlation, linear models, and Bland-Altman (BA) analysis. Ten patients had 3-4 h of continuous uninterrupted ICP and TCD data and were used for this pilot analysis. Optimal ARIMA structure for PRx was determined to be (2,0,2), and this was embedded in all LME models. The top two LME models of PRx were determined to be: PRx ∼ Sx_a and PRx ∼ Sx_a + Mx_a. Estimated and observed PRx values from both models were strongly correlated (r > 0.9; p < 0.0001 for both), with acceptable agreement on BA analysis. Predicted PRx using these two models was also moderately correlated with observed PRx, with acceptable agreement (r = 0.797, p = 0.006; r = 0.763, p = 0.011; respectively). With application of ARIMA and LME modeling, it is possible to predict PRx using non-invasive TCD measures. These are the first and as well as being preliminary attempts at doing so. Much further work is required.
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.30421
dc.identifier.eissn1557-9042
dc.identifier.issn0897-7151
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/283058
dc.languageeng
dc.language.isoeng
dc.publisherMary Ann Liebert Inc
dc.publisher.urlhttp://dx.doi.org/10.1089/neu.2018.5987
dc.subjectTBI
dc.subjectTCD
dc.subjectautoregulation
dc.subjectbrain injury
dc.subjecttime series
dc.subjectBrain Injuries, Traumatic
dc.subjectCerebrovascular Circulation
dc.subjectHumans
dc.subjectIntracranial Pressure
dc.subjectMiddle Cerebral Artery
dc.subjectModels, Neurological
dc.subjectMonitoring, Physiologic
dc.subjectPilot Projects
dc.subjectRobotics
dc.subjectSignal Processing, Computer-Assisted
dc.subjectUltrasonography, Doppler, Transcranial
dc.titleNon-Invasive Pressure Reactivity Index Using Doppler Systolic Flow Parameters: A Pilot Analysis.
dc.typeArticle
dcterms.dateAccepted2018-08-06
prism.endingPage720
prism.issueIdentifier5
prism.publicationDate2019
prism.publicationNameJ Neurotrauma
prism.startingPage713
prism.volume36
pubs.funder-project-idEuropean Commission (602150)
rioxxterms.licenseref.startdate2019-03
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionAM
rioxxterms.versionofrecord10.1089/neu.2018.5987

Files

Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Predicting PRx - JNT - Final Accepted.pdf
Size:
1 MB
Format:
Adobe Portable Document Format
Description:
Accepted version
Licence
http://www.rioxx.net/licenses/all-rights-reserved
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
DepositLicenceAgreement.pdf
Size:
417.78 KB
Format:
Adobe Portable Document Format