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01-11-2017 | Editorial (by Invitation)

Pressure reactivity index: journey through the past 20 years

Authors: Marek Czosnyka, Zofia Czosnyka, Peter Smielewski

Published in: Acta Neurochirurgica | Issue 11/2017

Abstract

Autoregulation after traumatic brain injury can be monitored continuously using simple signal processing of intracranial pressure and arterial blood pressure. The pressure reactivity index (PRx) showed several benefits when it was applied to continuous brain monitoring. Among them, a positive and strong correlation with the outcome and possibility of calculation of ‘optimal cerebral perfusion pressure’ have been listed. For this methodology, prospective clinical trials are missing—few of them are planned in the near future.

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Brady K, Joshi B, Zweifel C, Smielewski P, Czosnyka M, Easley RB, Hogue CW Jr (2010) Real-time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass. Stroke 41(9):1951–1956CrossRefPubMedPubMedCentral

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da Costa CS, Czosnyka M, Smielewski P, Mitra S, Stevenson GN, Austin T (2015) Monitoring of Cerebrovascular reactivity for determination of optimal blood pressure in preterm infants. J Pediatr 167(1):86–91CrossRefPubMed

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10.

Dias C, Silva MJ, Pereira E, Monteiro E, Maia I, Barbosa S, Silva S, Honrado T, Cerejo A, Aries MJ, Smielewski P, Paiva JA, Czosnyka M (2015) Optimal cerebral perfusion pressure Management at Bedside: a single-Center pilot study. Neurocrit Care 23(1):92–102CrossRefPubMed

11.

Fraser CD 3rd, Brady KM, Rhee CJ, Easley RB, Kibler K, Smielewski P, Czosnyka M, Kaczka DW, Andropoulos DB, Rusin C (2013) The frequency response of cerebral autoregulation. J Appl Physiol 1 115(1):52–56CrossRef

12.

Güiza F, Meyfroidt G, Piper I, Citerio G, Chambers I, Enblad P, Nillson P, Feyen B, Jorens P, Maas A, Schuhmann MU, Donald R, Moss L, Van den Berghe G, Depreitere B (2017) Cerebral perfusion pressure insults and associations with outcome in adult traumatic brain injury. J Neurotrauma 34(16):2425–2431CrossRefPubMedPubMedCentral

13.

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14.

Lang EW, Kasprowicz M, Smielewski P, Santos E, Pickard J, Czosnyka M (2015) Short pressure reactivity index versus long pressure reactivity index in the management of traumatic brain injury. J Neurosurg 122(3):588–594CrossRefPubMed

15.

Lazaridis C, DeSantis SM, Smielewski P, Menon DK, Hutchinson P, Pickard JD, Czosnyka M (2014) Patient-specific thresholds of intracranial pressure in severe traumatic brain injury. J Neurosurg 120(4):893–900CrossRefPubMed

16.

Lee JK, Kibler KK, Benni PB, Easley RB, Czosnyka M, Smielewski P, Koehler RC, Shaffner DH, Brady KM (2009) Cerebrovascular reactivity measured by near-infrared spectroscopy. Stroke 40(5):1820–1826CrossRefPubMed

17.

Liu X, Donnelly J, Czosnyka M, Aries MJH, Brady K, Cardim D, Robba C, Cabeleira M, Kim DJ, Haubrich C, Hutchinson PJ, Smielewski P (2017) Cerebrovascular pressure reactivity monitoring using wavelet analysis in traumatic brain injury patients: a retrospective study. PLoS Med 14(7):e1002348CrossRefPubMedPubMedCentral

18.

Sorrentino E, Diedler J, Kasprowicz M, Budohoski KP, Haubrich C, Smielewski P, Outtrim JG, Manktelow A, Hutchinson PJ, Pickard JD, Menon DK, Czosnyka M (2012) Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care 16(2):258–266CrossRefPubMed

19.

Steiner LA, Czosnyka M, Piechnik SK, Smielewski P, Chatfield D, Menon DK, Pickard JD (2002) Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury. Crit Care Med 30(4):733–738CrossRefPubMed

20.

Zweifel C, Castellani G, Czosnyka M, Helmy A, Manktelow A, Carrera E, Brady KM, Hutchinson PJ, Menon DK, Pickard JD, Smielewski P (2010) Noninvasive monitoring of cerebrovascular reactivity with near infrared spectroscopy in head-injured patients. J Neurotrauma 27(11):1951–1958CrossRefPubMed

Title: Pressure reactivity index: journey through the past 20 years
Authors: Marek Czosnyka
Zofia Czosnyka
Peter Smielewski
Publication date: 01-11-2017
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-017-3310-1

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Pressure reactivity index: journey through the past 20 years

Abstract

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Abstract

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