Observation of Autoregulation Indices During Ventricular CSF Drainage After Aneurysmal Subarachnoid Hemorrhage: A Pilot Study

Neurocritical Care
Marcel J H AriesJan Willem J Elting

Abstract

Cerebral autoregulation is increasingly recognized as a factor that requires evaluation when managing poor grade aneurysmal subarachnoidal hemorrhage (aSAH) patients. In this single center pilot study, we investigated whether intraventricular intracranial pressure (ICP) derived when extraventricular drain (EVD) is open can be used to calculate dynamic autoregulation estimates in ICU aSAH patients. Ten patients with the diagnosis of aSAH as confirmed by computed tomography (CT) and CT-angiography were enrolled. ICP was monitored via a transducer connected to the most proximal side exit of the EVD catheter. From at least 30 min periods of brain monitoring before, during, and after temporarily EVD closure, commonly used indexes of dynamic cerebral autoregulation were calculated. Preserved pulsatile ICP signals were seen with open EVD. There were no significant changes in parameters describing cerebral autoregulation between EVD open and closed conditions. Power spectra of ABP and ICP showed no significant changes for the selected frequency ranges. There was a small significant increase in absolute ICP [2.4 (3.8) mmHg, p < 0.001] upon short-term EVD closure. Cerebral spinal reserve capacity (RAP index) worsened significantly by sho...Continue Reading

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Citations

Mar 19, 2016·Journal of Clinical Monitoring and Computing·Tim HowellsPer Enblad
Jun 7, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Ya-Suo DingGuang-Zhong Gao
Sep 10, 2019·Stroke; a Journal of Cerebral Circulation·Andrew SilvermanNils H Petersen
Mar 4, 2021·Neurocritical Care·Andreas H Kramer

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