About: Intracranial-to-central venous pressure gap predicts the responsiveness of intracranial pressure to PEEP in patients with traumatic brain injury: a prospective cohort study

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About: Intracranial-to-central venous pressure gap predicts the responsiveness of intracranial pressure to PEEP in patients with traumatic brain injury: a prospective cohort study Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Intracranial-to-central venous pressure gap predicts the responsiveness of intracranial pressure to PEEP in patients with traumatic brain injury: a prospective cohort study
Creator	Li, Qing Li, Hong Lin, Ying Cheng, Zhi Qu, Wei Zhang, Liu
Source	PMC
abstract	BACKGROUND: Mechanical ventilation (MV) with positive end-expiratory pressure (PEEP) is commonly applied in patients with severe traumatic brain injury (sTBI). However, the individual responsiveness of intracranial pressure (ICP) to PEEP varies. Thus, identifying an indicator detecting ICP responsiveness to PEEP is of great significance. As central venous pressure (CVP) could act as an intermediary to transduce pressure from PEEP to ICP, we developed a new indicator, P(IC)Gap, representing the gap between baseline ICP and baseline CVP. The aim of the current study was to explore the relationship between P(IC)Gap and ICP responsiveness to PEEP. METHODS: A total of 112 patients with sTBI undergoing MV were enrolled in this prospective cohort study. ICP, CVP, cerebral perfusion pressure (CPP), static compliance of the respiratory system (Cst), and end-tidal carbon dioxide pressure (PetCO(2)) were recorded at the initial (3 cmH(2)O) and adjusted (15 cmH(2)O) levels of PEEP. P(IC)Gap was assessed as baseline ICP - baseline CVP (when PEEP = 3 cmH(2)O). The patients were classified into the ICP responder and non-responder groups based on whether ICP increment with PEEP adjusted from 3 cmH(2)O to 15 cmH(2)O was greater than 20% of baseline ICP. The above parameters were compared between the two groups, and prediction of ICP responsiveness to PEEP adjustment was evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS: Compared with the non-responder group, the responder group had lower P(IC)Gap (1.63 ± 1.33 versus 6.56 ± 2.46 mmHg; p < 0.001), lower baseline ICP, and higher baseline CVP. ROC curve analysis suggested that P(IC)Gap was a stronger predictive indicator of ICP responsiveness to PEEP (AUC = 0.957, 95%CI 0.918–0.996; p < 0.001) compared with baseline ICP and baseline CVP, with favorable sensitivity (95.24, 95%CI 86.91–98.70%) and specificity (87.6, 95%CI 75.76–94.27%), at a cut off value of 2.5 mmHg. CONCLUSION: The impact of PEEP on ICP depends on the gap between baseline ICP and baseline CVP, i.e. P(IC)Gap. In addition, P(IC)Gap is a potential predictor of ICP responsiveness to PEEP adjustment in patients with sTBI.
has issue date	2020-06-08(xsd:dateTime)
bibo:doi	10.1186/s12883-020-01764-7
has license	cc-by
sha1sum (hex)	49a0273a627fbc7be22560e31e484e7481b39b7b
schema:url	https://doi.org/10.1186/s12883-020-01764-7
resource representing a document's title	Intracranial-to-central venous pressure gap predicts the responsiveness of intracranial pressure to PEEP in patients with traumatic brain injury: a prospective cohort study
has PubMed Central identifier	PMC7276961
schema:publication	BMC Neurol
resource representing a document's body	covid:49a0273a627fbc7be22560e31e484e7481b39b7b#body_text
is schema:about of	named entity 'positive end-expiratory pressure' named entity 'central venous pressure' named entity 'PEEP' named entity 'transduce' named entity 'PEEP' named entity 'traumatic brain injury' named entity 'central venous pressure' named entity 'CPP' named entity 'CVP' named entity 'venous pressure' named entity 'SPSS' named entity 'PEEP' named entity 'PEEP' named entity 'PEEP' named entity 'PEEP' named entity 'PEEP' named entity 'CPP' named entity 'catheter' named entity 'central venous pressure' named entity 'bloating' named entity 'high levels' named entity 'MAP' named entity 'catheter' named entity 'lung' named entity 'PEEP' named entity 'CPP' named entity 'ROC' named entity 'Starling resistor' named entity 'CVP' named entity 'PEEP' named entity 'PEEP' named entity 'downregulation' named entity 'CVP' named entity 'PEEP' named entity 'central venous pressure' named entity 'cerebral edema' named entity 'radiography' named entity 'PEEP' named entity 'mmHg' named entity 'PEEP' named entity 'PEEP' named entity 'CVP' named entity 'mmHg' named entity 'CPP' named entity 'ICU' named entity 'intracranial pressure' named entity 'hypoxemia' named entity 'supine position' named entity 'functional residual capacity' named entity 'CVP' named entity 'oxygen saturation' named entity 'ROC' named entity 'venous return' named entity 'PetCO' named entity 'neurosurgical' named entity 'PEEP' named entity 'ventilator' named entity 'alveolar' named entity 'CVP' named entity 'PEEP' named entity 'PEEP' named entity 'CPP' named entity 'arterial pressure' named entity 'Dräger' named entity 'pneumoperitoneum' named entity 'hypoxemia' named entity 'statistically significant' named entity 'ROC' named entity 'PEEP' named entity 'CVP' named entity 'CVP' named entity 'PEEP' named entity 'CVP' named entity 'PEEP' named entity 'hemodynamic' named entity 'sample size' named entity 'PEEP' named entity 'external ventricular drain'

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