Characterization of the Relationship Between Intracranial Pressure and Electroencephalographic Monitoring in Burst-Suppressed Patients

Connolly, Mark; Vespa, Paul; Pouratian, Nader; Gonzalez, Nestor R.; Hu, Xiao

doi:10.1007/s12028-014-0059-8

Cited by 29 publications

(43 citation statements)

References 31 publications

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“…This is a significant undertaking and will be pursued in a separate work, however, it is important to note that mean ICP is generally used clinically for diagnosis of intracranial hypertension. Nonetheless, it is expected that improved modeling of CSF and ICP dynamics will improve the predictive capabilities of even mean ICP, and moreover emerging research 8,3 is recognizing the importance of ICP waveform analysis for diagnosis and differentiation of cerebral pathologies and treatment management.…”

Section: Validation Against Clinical Datamentioning

confidence: 99%

Data-Augmented Modeling of Intracranial Pressure

Wang

Shadden

2019

Ann Biomed Eng

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Precise management of patients with cerebral diseases often requires intracranial pressure (ICP) monitoring, which is highly invasive and requires a specialized ICU setting. The ability to noninvasively estimate ICP is highly compelling as an alternative to, or screening for, invasive ICP measurement. Most existing approaches for noninvasive ICP estimation aim to build a regression function that maps noninvasive measurements to an ICP estimate using statistical learning techniques. These * data-based approaches have met limited success, likely because the amount of training data needed is onerous for this complex applications. In this work, we discuss an alternative strategy that aims to better utilize noninvasive measurement data by leveraging mechanistic understanding of physiology. Specifically, we developed a Bayesian framework that combines a multiscale model of intracranial physiology with noninvasive measurements of cerebral blood flow using transcranial Doppler. Virtual experiments with synthetic data are conducted to verify and analyze the proposed framework. A preliminary clinical application study on two patients is also performed in which we demonstrate the ability of this method to improve ICP prediction.

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Section: Validation Against Clinical Datamentioning

confidence: 99%

Data-Augmented Modeling of Intracranial Pressure

Wang

Shadden

2019

Ann Biomed Eng

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“…Specific EEG patterns are correlated with CBF . In particular, EEG burst duration correlates with ICP changes .…”

Section: Neurophysiological Registrations Of Functional Activitymentioning

confidence: 99%

Non-invasive assessment of intracranial pressure

et al. 2015

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Monitoring of intracranial pressure (ICP) is invaluable in the management of neurosurgical and neurological critically ill patients. Invasive measurement of ventricular or parenchymal pressure is considered the gold standard for accurate measurement of ICP but is not always possible due to certain risks. Therefore, the availability of accurate methods to non-invasively estimate ICP has the potential to improve the management of these vulnerable patients. This review provides a comparative description of different methods for non-invasive ICP measurement. Current methods are based on changes associated with increased ICP, both morphological (assessed with magnetic resonance, computed tomography, ultrasound, and fundoscopy) and physiological (assessed with transcranial and ophthalmic Doppler, tympanometry, near-infrared spectroscopy, electroencephalography, visual-evoked potentials, and otoacoustic emissions assessment). At present, none of the non-invasive techniques alone seem suitable as a substitute for invasive monitoring. However, following the present analysis and considerations upon each technique, we propose a possible flowchart based on the combination of non-invasive techniques including those characterizing morphologic changes (e.g., repetitive US measurements of ONSD) and those characterizing physiological changes (e.g., continuous TCD). Such an integrated approach, which still needs to be validated in clinical practice, could aid in deciding whether to place an invasive monitor, or how to titrate therapy when invasive ICP measurement is contraindicated or unavailable.

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“…Of the 7 articles included in the review, [7][8][9][10][11][12][13] all were original studies. One article was a published meeting proceeding.…”

Section: Resultsmentioning

confidence: 99%

“…1,6 Only a small number of studies document the impact of burst suppression therapy on ICP control. [7][8][9][10][11][12][13] The goal of our study is to perform a systematic review of the literature on targeting burst suppression and its effects on ICP in patients with neurological illness.…”

Section: Introductionmentioning

confidence: 99%

Burst Suppression for ICP Control

Zeiler

Akoth

Gillman

et al. 2016

J Intensive Care Med

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There currently exists both Oxford level 2b and GRADE C evidence to support that achieving burst suppression reduces ICP, and also has no effect on ICP, in severe traumatic brain injury. The literature suggests burst suppression therapy may be useful for ICP reduction in certain cases, although these situations are currently unclear. In addition, the impact on patient functional outcome is unclear. Further prospective study is warranted.

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Characterization of the Relationship Between Intracranial Pressure and Electroencephalographic Monitoring in Burst-Suppressed Patients

Cited by 29 publications

References 31 publications

Data-Augmented Modeling of Intracranial Pressure

Data-Augmented Modeling of Intracranial Pressure

Non-invasive assessment of intracranial pressure

Burst Suppression for ICP Control

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