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Neurocritical Care
Published in: Neurocritical Care 3/2015

01-12-2015 | Translational Research

Doppler Non-invasive Monitoring of ICP in an Animal Model of Acute Intracranial Hypertension

Authors: Chiara Robba, Joseph Donnelly, Rita Bertuetti, Danilo Cardim, Mypinder S. Sekhon, Marcel Aries, Peter Smielewski, Hugh Richards, Marek Czosnyka

Published in: Neurocritical Care | Issue 3/2015

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Abstract

Background

In many neurological diseases, intracranial pressure (ICP) is elevated and needs to be actively managed. ICP is typically measured with an invasive transducer, which carries risks. Non-invasive techniques for monitoring ICP (nICP) have been developed. The aim of this study was to compare three different methods of transcranial Doppler (TCD) assessment of nICP in an animal model of acute intracranial hypertension.

Methods

In 28 rabbits, ICP was increased to 70–80 mmHg by infusion of Hartmann’s solution into the lumbar subarachnoid space. Doppler flow velocity in the basilar artery was recorded. nICP was assessed through three different methods: Gosling’s pulsatility index PI (gPI), Aaslid’s method (AaICP), and a method based on diastolic blood flow velocity (FVdICP).

Results

We found a significant correlation between nICP and ICP when all infusion experiments were combined (FVdICP: r = 0.77, AaICP: r = 0.53, gPI: r = 0.54). The ability to distinguish between raised and ‘normal’ values of ICP was greatest for FVdICP (AUC 0.90 at ICP >40 mmHg). When infusion experiments were considered independently, FVdICP demonstrated again the strongest correlation between changes in ICP and changes in nICP (mean r = 0.85).

Conclusions

TCD-based methods of nICP monitoring are better at detecting changes of ICP occurring in time, rather than absolute prediction of ICP as a number. Of the studied methods of nICP, the method based on FVd is best to discriminate between raised and ‘normal’ ICP and to monitor relative changes of ICP.
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Metadata
Title
Doppler Non-invasive Monitoring of ICP in an Animal Model of Acute Intracranial Hypertension
Authors
Chiara Robba
Joseph Donnelly
Rita Bertuetti
Danilo Cardim
Mypinder S. Sekhon
Marcel Aries
Peter Smielewski
Hugh Richards
Marek Czosnyka
Publication date
01-12-2015
Publisher
Springer US
Published in
Neurocritical Care / Issue 3/2015
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-015-0163-4

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