Published in:
01-04-2021 | Central Nervous System Trauma | Letter to the Editor
Anti-decubitus bed mattress may interfere with cerebrovascular pressure reactivity measures due to induced ICP and ABP cyclic peaks
Authors:
Tas Jeanette, Borg Melisa, Smielewski Peter, Czosnyka Marek, Beqiri Erta, Ercole Ari, Aries Marcel
Published in:
Journal of Clinical Monitoring and Computing
|
Issue 2/2021
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Abstract
Severe traumatic brain injury (TBI) patients are monitored with continuous arterial blood pressure (ABP) and intracranial pressure (ICP). The pressure reactivity index (PRx) is a frequently used correlation coefficient between ABP and ICP to inform clinicians at the bedside about trends in global cerebrovascular pressure regulation status. We present an unexpected influence of cyclic anti-decubitus mattress inflations and deflations on invasive ICP, ABP and PRx calculations in our TBI patients. This might affect autoregulation guided management. In our database, 23% (9/39) of the patients show recurrent peaks in the monitoring signals. We hypothesize that these peaks are caused by (a combination) of hydrostatic change, local (cervical) compression and/or incorrect sensor zeroing due to positional changes induced by the anti-decubitus mattress. This warrants further investigation by the manufacturer and exploration of data filters.