不同的非侵入性神经监测工具的相关性,评估内血液动力学
Rossella Zangari1,2, Luca D'Amelio2, Elisa Gouvea Bogossian2
1Department of Intensive Care and Emergency, Spedali Civili di Brescia, Università degli Studi di Brescia, 25121 Brescia, Italy.
Brain sciences
|July 29, 2025
概括
非侵入性内压力 (ICP) 监测工具显示有限的一致性,对于急性脑损伤患者来说是不可互换的. 建议采用多模式方法来准确估计ICP.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 生物医学工程 生物医学工程
背景情况:
- 内压力 (ICP) 监测对于管理急性脑损伤 (ABI) 和预防二次脑损伤至关重要.
- 侵入性ICP监测虽然有效,但存在感染和出血等风险.
- 非侵入性技术提供了更安全的替代方案,但它们的比较性能需要系统的评估.
研究的目的:
- 评估ABI患者四种常见的非侵入性神经监测工具之间的相关性和一致性.
- 为了比较视神经外直径 (ONSD),脉动率指数 (PI),估计的ICP (eICP) 和神经学瞳孔指数 (NPi) 与侵入性ICP监测.
主要方法:
- 对从100名重症监护病房中受创性脑损伤,下大脑关节出血或脑内出血的患者前性收集的数据的二次分析.
- 在侵入性ICP监测期间,同时测量了ONSD,PI,eICP和NPi.
- 使用斯皮尔曼相关系数 (ρ) 和科恩卡帕系数 (k) 来评估相关性和一致性.
主要成果:
- 在ONSD和PI (ρ=0.29),ONSD和NPi (ρ=-0.33),PI和NPi (ρ=-0.33) 之间观察到较弱的相关性.
- 在ONSD和eICP (ρ=0.54) 和PI和eICP (ρ=0.48) 之间发现了中度的相关性.
- 在eICP和NPI之间存在强烈的反相关性 (ρ=-0.71). 一致性一般很低,PI和eICP之间的一致性最高 (k=0.69).
结论:
- 非侵入性神经监测工具表现出可变的相关性和有限的一致性,表明它们不能互换.
- 每种模式都为大脑生理学提供了独特的见解.
- 结合这些工具的多模式策略可以提高ABI管理中的ICP估计的准确性.
相关概念视频
01:30Equipments Used To Measure Blood Pressure
Direct Method
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...
01:19Assessing Blood pressure using a doppler ultrasound
To obtain accurate blood pressure measurements in clinical settings, especially when traditional methods are insufficient, healthcare professionals utilize the Doppler ultrasound technique. This method uses high-frequency sound waves to detect blood flow within the arteries, which is crucial for patients with conditions that complicate circulatory system assessment.
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
01:17Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.