Research Reports - Intracranial pressure dose and outcome in traumatic brain injury

Neurocrit Care. 2012 Oct 9

Sheth KN, Stein DM, Aarabi B, Hu P, Kufera JA, Scalea TM, Hanley DF

OBJECTIVE: Detecting and treating elevated intracranial pressure (ICP) is a
cornerstone of management in patients with severe traumatic brain injury. The aim
of this study was to determine the association between area under the curve
measurement of elevated ICP and clinical outcome. METHODS: Single center
observational study using prospectively collected data at a University hospital,
level one-trauma center. Sixty prospective patients with severe traumatic brain
injury were prospectively enrolled over a 2-year period. Intracranial pressure
measurements were captured using a real-time automated, high resolution vital
signs data recording system. Mortality and functional outcome were assessed at
30 days, 3 and 6 months using Extended Glasgow Outcome Scale. RESULTS: Increasing
elevated intracranial pressure time dose was associated with mortality (OR 1.08;
95 % confidence interval [CI], 1.01-1.15, p = 0.03) and poor functional outcome
at 3 (OR 1.04; CI 1.00-1.07, p = 0.03) and 6 months (1.04; CI 1.01-1.08,
p = 0.02). However, there was no association between episodic ICP data and
outcome. CONCLUSIONS: These results suggest that pressure time dose measurement
of intracranial pressure may be used to predict outcome in severe traumatic brain
injury and may be a candidate biomarker in this disease.

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