Xiuyun Liu, Joseph Donnelly, Marek Czosnyka, Marcel J H Aries, Ken Brady, Danilo Cardim, Chiara Robba, Manuel Cabeleira, Christina Haubrich, Peter J Hutchinson, Peter Smielewski, Dong-Joo Kim (Korea University)
PLoS Medicine (2017)
Abstract:
- After traumatic brain injury (TBI), cerebral pressure reactivity (vessels responding to blood pressure changes) can be impaired, increasing risk of abnormal perfusion.
- Traditional pressure reactivity index (PRx) – erratic in clinical use.
- Introduces a wavelet transform-based pressure reactivity index (wPRx) and compares it to PRx in TBI patients.
- Goal: assess stability over time, ability to recommend optimal cerebral perfusion pressure (CPPopt), and association with outcomes.
Findings:
- The wavelet-based index wPRx was more stable over time than traditional PRx.
- wPRx provided a more consistent optimal CPP (CPPopt) than PRx, with lower variability.
- wPRx had a stronger relationship with patient outcome
- Both data correlated, but wPRx showed improved reliability and medical value.
Conclusion:
- Found wPRx to be more stable in time and yield a more consistent CPPopt recommendation compared to PRx.
- wPRx had a stronger relationship with patient outcome compared to PRx in our study
- wPRx performed better in distinguishing different patient outcome groups
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