内压力作为创伤性脑损伤结果的动态预测器:一个范围审查
John H Kanter1,2, Robert C Osorio3, Abel Torres-Espin4,5
1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Journal of neurotrauma
|September 29, 2025
概括
在严重创伤性脑损伤 (TBI) 中,连续内压力 (ICP) 监测预测了结果. 将ICP数据与脑血管活性结合起来,并使用机器学习,显示了个性化的TBI管理的前景.
科学领域:
- 神经外科 神经外科
- 临界护理医学 临界护理医学
- 神经学 神经学
背景情况:
- 内压力 (ICP) 监测对于严重创伤性脑损伤 (TBI) 管理至关重要.
- 它作为一个动态结果预测器的作用在不断发展.
- 对于ICP分析,包括机器学习在内的先进建模正在出现.
研究的目的:
- 评估连续ICP测量作为TBI结果的预测器.
- 将ICP数据与脑血管活性指标整合起来.
- 确定ICP建模的趋势,特别是机器学习方法.
主要方法:
- 根据PRISMA-ScR指南进行了范围审查.
- 系统的数据库搜索涵盖了1998年1月至2024年8月的出版物.
- 综合了29项研究 (N=5,743名患者) 的数据.
主要成果:
- 特定的ICP模式与临床结果有显著的相关性,包括死亡率.
- 早期ICP监测 (72小时内) 和依赖值的预测是有价值的.
- 将ICP与脑血管反应性相结合,可以提高预测准确度.
结论:
- 动态ICP模式与TBI中的死亡率和功能结果密切相关.
- ICP越来越多地被视为一个多维度指标.
- 机器学习和先进技术为精确的TBI医学提供了潜力,但需要标准化.
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