Cerebrovascular pressure reactivity monitoring using wavelet analysis in traumatic brain injury patients: A retrospective study
After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is impaired, leaving patients vulnerable to cerebral hypo- or hyperperfusion. Although, the traditional pressure reactivity index (PRx) has demonstra...
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| Published in | PLoS medicine Vol. 14; no. 7; p. e1002348 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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United States
Public Library of Science
01.07.2017
Public Library of Science (PLoS) |
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| Abstract | After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is impaired, leaving patients vulnerable to cerebral hypo- or hyperperfusion. Although, the traditional pressure reactivity index (PRx) has demonstrated that impaired pressure reactivity is associated with poor patient outcome, PRx is sometimes erratic and may not be reliable in various clinical circumstances. Here, we introduce a more robust transform-based wavelet pressure reactivity index (wPRx) and compare its performance with the widely used traditional PRx across 3 areas: its stability and reliability in time, its ability to give an optimal cerebral perfusion pressure (CPPopt) recommendation, and its relationship with patient outcome.
Five hundred and fifteen patients with TBI admitted in Addenbrooke's Hospital, United Kingdom (March 23rd, 2003 through December 9th, 2014), with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP), were retrospectively analyzed to calculate the traditional PRx and a novel wavelet transform-based wPRx. wPRx was calculated by taking the cosine of the wavelet transform phase-shift between ABP and ICP. A time trend of CPPopt was calculated using an automated curve-fitting method that determined the cerebral perfusion pressure (CPP) at which the pressure reactivity (PRx or wPRx) was most efficient (CPPopt_PRx and CPPopt_wPRx, respectively). There was a significantly positive relationship between PRx and wPRx (r = 0.73), and wavelet wPRx was more reliable in time (ratio of between-hour variance to total variance, wPRx 0.957 ± 0.0032 versus PRx and 0.949 ± 0.047 for PRx, p = 0.002). The 2-hour interval standard deviation of wPRx (0.19 ± 0.07) was smaller than that of PRx (0.30 ± 0.13, p < 0.001). wPRx performed better in distinguishing between mortality and survival (the area under the receiver operating characteristic [ROC] curve [AUROC] for wPRx was 0.73 versus 0.66 for PRx, p = 0.003). The mean difference between the patients' CPP and their CPPopt was related to outcome for both calculation methods. There was a good relationship between the 2 CPPopts (r = 0.814, p < 0.001). CPPopt_wPRx was more stable than CPPopt_PRx (within patient standard deviation 7.05 ± 3.78 versus 8.45 ± 2.90; p < 0.001). Key limitations include that this study is a retrospective analysis and only compared wPRx with PRx in the cohort of patients with TBI. Prior prospective validation is required to better assess clinical utility of this approach.
wPRx offers several advantages to the traditional PRx: it is more stable in time, it yields a more consistent CPPopt recommendation, and, importantly, it has a stronger relationship with patient outcome. The clinical utility of wPRx should be explored in prospective studies of critically injured neurological patients. |
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| AbstractList | Background After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is impaired, leaving patients vulnerable to cerebral hypo- or hyperperfusion. Although, the traditional pressure reactivity index (PRx) has demonstrated that impaired pressure reactivity is associated with poor patient outcome, PRx is sometimes erratic and may not be reliable in various clinical circumstances. Here, we introduce a more robust transform-based wavelet pressure reactivity index (wPRx) and compare its performance with the widely used traditional PRx across 3 areas: its stability and reliability in time, its ability to give an optimal cerebral perfusion pressure (CPPopt) recommendation, and its relationship with patient outcome. Methods and findings Five hundred and fifteen patients with TBI admitted in Addenbrooke’s Hospital, United Kingdom (March 23rd, 2003 through December 9th, 2014), with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP), were retrospectively analyzed to calculate the traditional PRx and a novel wavelet transform-based wPRx. wPRx was calculated by taking the cosine of the wavelet transform phase-shift between ABP and ICP. A time trend of CPPopt was calculated using an automated curve-fitting method that determined the cerebral perfusion pressure (CPP) at which the pressure reactivity (PRx or wPRx) was most efficient (CPPopt_PRx and CPPopt_wPRx, respectively). There was a significantly positive relationship between PRx and wPRx (r = 0.73), and wavelet wPRx was more reliable in time (ratio of between-hour variance to total variance, wPRx 0.957 ± 0.0032 versus PRx and 0.949 ± 0.047 for PRx, p = 0.002). The 2-hour interval standard deviation of wPRx (0.19 ± 0.07) was smaller than that of PRx (0.30 ± 0.13, p < 0.001). wPRx performed better in distinguishing between mortality and survival (the area under the receiver operating characteristic [ROC] curve [AUROC] for wPRx was 0.73 versus 0.66 for PRx, p = 0.003). The mean difference between the patients’ CPP and their CPPopt was related to outcome for both calculation methods. There was a good relationship between the 2 CPPopts (r = 0.814, p < 0.001). CPPopt_wPRx was more stable than CPPopt_PRx (within patient standard deviation 7.05 ± 3.78 versus 8.45 ± 2.90; p < 0.001). Key limitations include that this study is a retrospective analysis and only compared wPRx with PRx in the cohort of patients with TBI. Prior prospective validation is required to better assess clinical utility of this approach. Conclusions wPRx offers several advantages to the traditional PRx: it is more stable in time, it yields a more consistent CPPopt recommendation, and, importantly, it has a stronger relationship with patient outcome. The clinical utility of wPRx should be explored in prospective studies of critically injured neurological patients. Background After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is impaired, leaving patients vulnerable to cerebral hypo- or hyperperfusion. Although, the traditional pressure reactivity index (PRx) has demonstrated that impaired pressure reactivity is associated with poor patient outcome, PRx is sometimes erratic and may not be reliable in various clinical circumstances. Here, we introduce a more robust transform-based wavelet pressure reactivity index (wPRx) and compare its performance with the widely used traditional PRx across 3 areas: its stability and reliability in time, its ability to give an optimal cerebral perfusion pressure (CPPopt) recommendation, and its relationship with patient outcome. Methods and findings Five hundred and fifteen patients with TBI admitted in Addenbrooke’s Hospital, United Kingdom (March 23rd, 2003 through December 9th, 2014), with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP), were retrospectively analyzed to calculate the traditional PRx and a novel wavelet transform-based wPRx. wPRx was calculated by taking the cosine of the wavelet transform phase-shift between ABP and ICP. A time trend of CPPopt was calculated using an automated curve-fitting method that determined the cerebral perfusion pressure (CPP) at which the pressure reactivity (PRx or wPRx) was most efficient (CPPopt_PRx and CPPopt_wPRx, respectively). There was a significantly positive relationship between PRx and wPRx (r = 0.73), and wavelet wPRx was more reliable in time (ratio of between-hour variance to total variance, wPRx 0.957 ± 0.0032 versus PRx and 0.949 ± 0.047 for PRx, p = 0.002). The 2-hour interval standard deviation of wPRx (0.19 ± 0.07) was smaller than that of PRx (0.30 ± 0.13, p < 0.001). wPRx performed better in distinguishing between mortality and survival (the area under the receiver operating characteristic [ROC] curve [AUROC] for wPRx was 0.73 versus 0.66 for PRx, p = 0.003). The mean difference between the patients’ CPP and their CPPopt was related to outcome for both calculation methods. There was a good relationship between the 2 CPPopts (r = 0.814, p < 0.001). CPPopt_wPRx was more stable than CPPopt_PRx (within patient standard deviation 7.05 ± 3.78 versus 8.45 ± 2.90; p < 0.001). Key limitations include that this study is a retrospective analysis and only compared wPRx with PRx in the cohort of patients with TBI. Prior prospective validation is required to better assess clinical utility of this approach. Conclusions wPRx offers several advantages to the traditional PRx: it is more stable in time, it yields a more consistent CPPopt recommendation, and, importantly, it has a stronger relationship with patient outcome. The clinical utility of wPRx should be explored in prospective studies of critically injured neurological patients. BackgroundAfter traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is impaired, leaving patients vulnerable to cerebral hypo- or hyperperfusion. Although, the traditional pressure reactivity index (PRx) has demonstrated that impaired pressure reactivity is associated with poor patient outcome, PRx is sometimes erratic and may not be reliable in various clinical circumstances. Here, we introduce a more robust transform-based wavelet pressure reactivity index (wPRx) and compare its performance with the widely used traditional PRx across 3 areas: its stability and reliability in time, its ability to give an optimal cerebral perfusion pressure (CPPopt) recommendation, and its relationship with patient outcome.Methods and findingsFive hundred and fifteen patients with TBI admitted in Addenbrooke's Hospital, United Kingdom (March 23rd, 2003 through December 9th, 2014), with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP), were retrospectively analyzed to calculate the traditional PRx and a novel wavelet transform-based wPRx. wPRx was calculated by taking the cosine of the wavelet transform phase-shift between ABP and ICP. A time trend of CPPopt was calculated using an automated curve-fitting method that determined the cerebral perfusion pressure (CPP) at which the pressure reactivity (PRx or wPRx) was most efficient (CPPopt_PRx and CPPopt_wPRx, respectively). There was a significantly positive relationship between PRx and wPRx (r = 0.73), and wavelet wPRx was more reliable in time (ratio of between-hour variance to total variance, wPRx 0.957 ± 0.0032 versus PRx and 0.949 ± 0.047 for PRx, p = 0.002). The 2-hour interval standard deviation of wPRx (0.19 ± 0.07) was smaller than that of PRx (0.30 ± 0.13, p < 0.001). wPRx performed better in distinguishing between mortality and survival (the area under the receiver operating characteristic [ROC] curve [AUROC] for wPRx was 0.73 versus 0.66 for PRx, p = 0.003). The mean difference between the patients' CPP and their CPPopt was related to outcome for both calculation methods. There was a good relationship between the 2 CPPopts (r = 0.814, p < 0.001). CPPopt_wPRx was more stable than CPPopt_PRx (within patient standard deviation 7.05 ± 3.78 versus 8.45 ± 2.90; p < 0.001). Key limitations include that this study is a retrospective analysis and only compared wPRx with PRx in the cohort of patients with TBI. Prior prospective validation is required to better assess clinical utility of this approach.ConclusionswPRx offers several advantages to the traditional PRx: it is more stable in time, it yields a more consistent CPPopt recommendation, and, importantly, it has a stronger relationship with patient outcome. The clinical utility of wPRx should be explored in prospective studies of critically injured neurological patients. After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is impaired, leaving patients vulnerable to cerebral hypo- or hyperperfusion. Although, the traditional pressure reactivity index (PRx) has demonstrated that impaired pressure reactivity is associated with poor patient outcome, PRx is sometimes erratic and may not be reliable in various clinical circumstances. Here, we introduce a more robust transform-based wavelet pressure reactivity index (wPRx) and compare its performance with the widely used traditional PRx across 3 areas: its stability and reliability in time, its ability to give an optimal cerebral perfusion pressure (CPPopt) recommendation, and its relationship with patient outcome. Five hundred and fifteen patients with TBI admitted in Addenbrooke's Hospital, United Kingdom (March 23rd, 2003 through December 9th, 2014), with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP), were retrospectively analyzed to calculate the traditional PRx and a novel wavelet transform-based wPRx. wPRx was calculated by taking the cosine of the wavelet transform phase-shift between ABP and ICP. A time trend of CPPopt was calculated using an automated curve-fitting method that determined the cerebral perfusion pressure (CPP) at which the pressure reactivity (PRx or wPRx) was most efficient (CPPopt_PRx and CPPopt_wPRx, respectively). There was a significantly positive relationship between PRx and wPRx (r = 0.73), and wavelet wPRx was more reliable in time (ratio of between-hour variance to total variance, wPRx 0.957 ± 0.0032 versus PRx and 0.949 ± 0.047 for PRx, p = 0.002). The 2-hour interval standard deviation of wPRx (0.19 ± 0.07) was smaller than that of PRx (0.30 ± 0.13, p < 0.001). wPRx performed better in distinguishing between mortality and survival (the area under the receiver operating characteristic [ROC] curve [AUROC] for wPRx was 0.73 versus 0.66 for PRx, p = 0.003). The mean difference between the patients' CPP and their CPPopt was related to outcome for both calculation methods. There was a good relationship between the 2 CPPopts (r = 0.814, p < 0.001). CPPopt_wPRx was more stable than CPPopt_PRx (within patient standard deviation 7.05 ± 3.78 versus 8.45 ± 2.90; p < 0.001). Key limitations include that this study is a retrospective analysis and only compared wPRx with PRx in the cohort of patients with TBI. Prior prospective validation is required to better assess clinical utility of this approach. wPRx offers several advantages to the traditional PRx: it is more stable in time, it yields a more consistent CPPopt recommendation, and, importantly, it has a stronger relationship with patient outcome. The clinical utility of wPRx should be explored in prospective studies of critically injured neurological patients. Using continuous monitoring data in traumatic brain inury patients, Xiuyun Liu and colleagues compare the performance of cerebrovascular pressure reactivity monitoring using wavelet analysis to the pressure reactivity index. |
| Author | Kim, Dong-Joo Haubrich, Christina Liu, Xiuyun Brady, Ken Robba, Chiara Cabeleira, Manuel Aries, Marcel J H Donnelly, Joseph Cardim, Danilo Hutchinson, Peter J Smielewski, Peter Czosnyka, Marek |
| AuthorAffiliation | 1 Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom 5 Department of Neuroscience, University of Genova, Genova, Italy 3 Department of Intensive Care, University of Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands Oregon Health and Science University, UNITED STATES 2 Institute of Electronic Systems, Warsaw University of Technology, Poland 6 Department of Brain & Cognitive Engineering, Korea University, Seoul, South Korea 7 Faculty of Medicine, University of Aachen, Germany 4 Baylor College of Medicine, Houston, Texas, United States of America |
| AuthorAffiliation_xml | – name: 4 Baylor College of Medicine, Houston, Texas, United States of America – name: 2 Institute of Electronic Systems, Warsaw University of Technology, Poland – name: Oregon Health and Science University, UNITED STATES – name: 3 Department of Intensive Care, University of Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands – name: 5 Department of Neuroscience, University of Genova, Genova, Italy – name: 6 Department of Brain & Cognitive Engineering, Korea University, Seoul, South Korea – name: 1 Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital, University of Cambridge, Cambridge, United Kingdom – name: 7 Faculty of Medicine, University of Aachen, Germany |
| Author_xml | – sequence: 1 givenname: Xiuyun orcidid: 0000-0001-9540-4865 surname: Liu fullname: Liu, Xiuyun organization: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom – sequence: 2 givenname: Joseph orcidid: 0000-0002-6502-8069 surname: Donnelly fullname: Donnelly, Joseph organization: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom – sequence: 3 givenname: Marek surname: Czosnyka fullname: Czosnyka, Marek organization: Institute of Electronic Systems, Warsaw University of Technology, Poland – sequence: 4 givenname: Marcel J H surname: Aries fullname: Aries, Marcel J H organization: Department of Intensive Care, University of Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands – sequence: 5 givenname: Ken orcidid: 0000-0002-3260-0233 surname: Brady fullname: Brady, Ken organization: Baylor College of Medicine, Houston, Texas, United States of America – sequence: 6 givenname: Danilo surname: Cardim fullname: Cardim, Danilo organization: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom – sequence: 7 givenname: Chiara orcidid: 0000-0003-1628-3845 surname: Robba fullname: Robba, Chiara organization: Department of Neuroscience, University of Genova, Genova, Italy – sequence: 8 givenname: Manuel orcidid: 0000-0002-1710-6544 surname: Cabeleira fullname: Cabeleira, Manuel organization: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom – sequence: 9 givenname: Dong-Joo surname: Kim fullname: Kim, Dong-Joo organization: Department of Brain & Cognitive Engineering, Korea University, Seoul, South Korea – sequence: 10 givenname: Christina surname: Haubrich fullname: Haubrich, Christina organization: Faculty of Medicine, University of Aachen, Germany – sequence: 11 givenname: Peter J surname: Hutchinson fullname: Hutchinson, Peter J organization: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom – sequence: 12 givenname: Peter orcidid: 0000-0001-5096-3938 surname: Smielewski fullname: Smielewski, Peter organization: Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28742798$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2017 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Liu X, Donnelly J, Czosnyka M, Aries MJH, Brady K, Cardim D, et al. (2017) Cerebrovascular pressure reactivity monitoring using wavelet analysis in traumatic brain injury patients: A retrospective study. PLoS Med 14(7): e1002348. https://doi.org/10.1371/journal.pmed.1002348 2017 Liu et al 2017 Liu et al 2017 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Liu X, Donnelly J, Czosnyka M, Aries MJH, Brady K, Cardim D, et al. (2017) Cerebrovascular pressure reactivity monitoring using wavelet analysis in traumatic brain injury patients: A retrospective study. PLoS Med 14(7): e1002348. https://doi.org/10.1371/journal.pmed.1002348 |
| Copyright_xml | – notice: 2017 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Liu X, Donnelly J, Czosnyka M, Aries MJH, Brady K, Cardim D, et al. (2017) Cerebrovascular pressure reactivity monitoring using wavelet analysis in traumatic brain injury patients: A retrospective study. PLoS Med 14(7): e1002348. https://doi.org/10.1371/journal.pmed.1002348 – notice: 2017 Liu et al 2017 Liu et al – notice: 2017 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Liu X, Donnelly J, Czosnyka M, Aries MJH, Brady K, Cardim D, et al. (2017) Cerebrovascular pressure reactivity monitoring using wavelet analysis in traumatic brain injury patients: A retrospective study. PLoS Med 14(7): e1002348. https://doi.org/10.1371/journal.pmed.1002348 |
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| Language | English |
| License | This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Creative Commons Attribution License |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ICM+ Software is licensed by Cambridge Enterprise, Cambridge, UK, http://www.neurosurg.cam.ac.uk/icmplus/. Peter Smielewski and Marek Czosnyka have a financial interest in a fraction of the licensing fee. |
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| References | DJ Thurman (ref1) 1999; 14 M Czosnyka (ref10) 1997; 41 A Lavinio (ref12) 2007; 99 RB Panerai (ref6) 2002; 23 a. Grinsted (ref19) 2004; 11 P Addison (ref17) 2002 B Depreitere (ref34) 2014; 120 DK Menon (ref20) 1999; 55 M Czosnyka (ref21) 1997; 41 PS Addison (ref24) 2002 I Timofeev (ref11) 2008; 108 JS Soul (ref7) 2007; 61 K Keissar (ref23) 2009; 367 B Depreitere (ref15) 2014; 120 JL Fleg (ref36) 1986; 57 J Donnelly (ref9) 2015 LA Steiner (ref13) 2002; 30 BJ Carey (ref33) 2003; 34 A PS (ref18) 2015; 8 K Keissar (ref22) 2009; 367 E Toledo (ref31) 2003; 284 M Wagner (ref38) 2012; 33 FP Tiecks (ref8) 1995; 26 Fenghua Tian (ref16) 2016 C Torrence (ref25) 1998; 79 K JF (ref2) 1993 ref29 B JENNETT (ref27) 1975 N a Obuchowski (ref28) 2003; 229 K Keissar (ref26) 2009; 367 P Kvandal (ref30) 2013; 27 MJH Aries (ref14) 2012; 40 N Lassen (ref4) 1959; 39 J Donnelly (ref3) 2016; 20 P Le Roux (ref5) 2014 WB Kannel (ref35) 1978; 54 AT Yam (ref32) 2005; 12 B Gribbin (ref37) 1971; 29 |
| References_xml | – start-page: 353 year: 2002 ident: ref24 article-title: The Illustrated Wavelet Transform Handbook: Applications in Science, Engineering, Medicine and Finance contributor: fullname: PS Addison – start-page: 480 year: 1975 ident: ref27 article-title: ASSESSMENT OF OUTCOME AFTER SEVERE BRAIN DAMAGE A Practical Scale [Internet] publication-title: The Lancet doi: 10.1016/S0140-6736(75)92830-5 contributor: fullname: B JENNETT – volume: 99 start-page: 237 year: 2007 ident: ref12 article-title: Cerebrovascular reactivity during hypothermia and rewarming publication-title: Br J Anaesth doi: 10.1093/bja/aem118 contributor: fullname: A Lavinio – volume: 39 start-page: 183 year: 1959 ident: ref4 article-title: Cerebral blood flow and oxygen consumption in man publication-title: Physiol Rev doi: 10.1152/physrev.1959.39.2.183 contributor: fullname: N Lassen – volume: 284 start-page: R1079 year: 2003 ident: ref31 article-title: Wavelet analysis of instantaneous heart rate: a 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autoregulation: New insights with quantitative T2-mapping and pulsed arterial spin-labeling MR publication-title: AJNR Am J Neuroradiol doi: 10.3174/ajnr.A3138 contributor: fullname: M Wagner – volume: 55 start-page: 226 year: 1999 ident: ref20 article-title: Cerebral protection in severe brain injury: physiological determinants of outcome and their optimisation publication-title: Br Med Bull doi: 10.1258/0007142991902231 contributor: fullname: DK Menon – volume: 120 start-page: 1451 year: 2014 ident: ref34 article-title: Pressure autoregulation monitoring and cerebral perfusion pressure target recommendation in patients with severe traumatic brain injury based on minute-by-minute monitoring data publication-title: J Neurosurg doi: 10.3171/2014.3.JNS131500 contributor: fullname: B Depreitere – year: 2002 ident: ref17 article-title: The Illustrated Wavelet Transform Handbook [Internet] contributor: fullname: P Addison – volume: 367 start-page: 1393 year: 2009 ident: ref23 article-title: 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Grinsted – volume: 41 start-page: 11 year: 1997 ident: ref21 article-title: Continuous assessment of the cerebral vasomotor reactivity in head injury publication-title: Neurosurgery doi: 10.1097/00006123-199707000-00005 contributor: fullname: M Czosnyka – volume: 14 start-page: 602 year: 1999 ident: ref1 article-title: Traumatic brain injury in the United States: A public health perspective publication-title: J Head Trauma Rehabil doi: 10.1097/00001199-199912000-00009 contributor: fullname: DJ Thurman – volume: 108 start-page: 66 year: 2008 ident: ref11 article-title: Effect of decompressive craniectomy on intracranial pressure and cerebrospinal compensation following traumatic brain injury publication-title: J Neurosurg doi: 10.3171/JNS/2008/108/01/0066 contributor: fullname: I Timofeev – volume: 54 start-page: 573 year: 1978 ident: ref35 article-title: Evaluation of cardiovascular risk in the elderly: the Framingham Study publication-title: Bull N Y Acad Med contributor: fullname: WB Kannel – volume: 8 start-page: 5960 year: 2015 ident: ref18 article-title: Identifying stable phase coupling associated with cerebral autoregulation using the synchrosqueezed cross-wavelet transform and low oscillation morlet wavelets publication-title: Conf Proc IEEE Eng Med Biol Soc contributor: fullname: A PS |
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| Snippet | After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure reactivity) is... Background After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure... BACKGROUNDAfter traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure... Using continuous monitoring data in traumatic brain inury patients, Xiuyun Liu and colleagues compare the performance of cerebrovascular pressure reactivity... BackgroundAfter traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure... Background After traumatic brain injury (TBI), the ability of cerebral vessels to appropriately react to changes in arterial blood pressure (pressure... |
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| SubjectTerms | Adult Biology and Life Sciences Blood Blood pressure Blood Pressure Determination - instrumentation Blood Pressure Determination - methods Brain Brain Injuries, Traumatic - diagnosis Cerebrovascular system Clinical outcomes Curve fitting England Female Heart rate Humans Injury analysis Intracranial Pressure Male Medicine and Health Sciences Methods Middle Aged Monitoring, Physiologic - methods Mortality Neurosciences Neurosurgery Patients People and Places Perfusion Physical Sciences Physiology Prognosis Reactivity Reproducibility of Results Research and Analysis Methods Respiration Retrospective Studies Software Standard deviation Studies Traumatic brain injury Variance Wavelet Analysis Wavelet transforms Young Adult |
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| Title | Cerebrovascular pressure reactivity monitoring using wavelet analysis in traumatic brain injury patients: A retrospective study |
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