Plateau Waves of Intracranial Pressure and Multimodal Brain Monitoring

• Type: Article in International Conference Proceedings Book
• Date: 2016

Authors

dias, c (Author) FMUP; Maia, I (Author) Other; Cerejo, A (Author) FMUP; Smielewski, P (Author) Other; Paiva, J-A (Author) FMUP; Czosnyka, M (Author) Other

Conference proceedings International

Title: INTRACRANIAL PRESSURE AND BRAIN MONITORING XV

Pages: 143-146

15th International Conference on Intracranial Pressure and Brain Monitoring (ICP)

Singapore, SINGAPORE, NOV 06-10, 2013

Indexing

ISI Web of Knowledge - 7 Citations

Scopus - 8 Citations

Other information

Authenticus ID: P-00K-GZ2

DOI: 10.1007/978-3-319-22533-3_29

Abstract (EN): The aim of this study was to describe multimodal brain monitoring characteristics during plateau waves of intracranial pressure (ICP) in patients with head injury, using ICM+ software for continuous recording. Plateau waves consist of an abrupt elevation of ICP above 40 mmHg for 5-20 min. This is a prospective observational study of patients with head injury who were admitted to a neurocritical care unit and who developed plateau waves. We analyzed 59 plateau waves that occurred in 8 of 18 patients (44 %). At the top of plateau waves arterial blood pressure remained almost constant, but cerebral perfusion pressure, cerebral blood flow, brain tissue oxygenation, and cerebral oximetry decreased. After plateau waves, patients with a previously better autoregulation status developed hyperemia, demonstrated by an increase in cerebral blood flow and brain oxygenation. Pressure and oxygen cerebrovascular reactivity indexes (pressure reactivity index and ORxshort) increased significantly during the plateau wave as a sign of disruption of autoregulation. Bedside multimodal brain monitoring is important to characterize increases in ICP and give differential diagnoses of plateau waves, as management of this phenomenon differs from that of regular ICP.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 4