Biomaterial Database

Beyond intracranial pressure: monitoring cerebral perfusion and autoregulation in severe traumatic brain injury. 2023

Sofie Dietvorst, and Bart Depreitere, and Geert Meyfroidt

Department of Neurosurgery.

Severe traumatic brain injury (TBI) remains the most prevalent neurological condition worldwide. Observational and interventional studies provide evidence to recommend monitoring of intracranial pressure (ICP) in all severe TBI patients. Existing guidelines focus on treating elevated ICP and optimizing cerebral perfusion pressure (CPP), according to fixed universal thresholds. However, both ICP and CPP, their target thresholds, and their interaction, need to be interpreted in a broader picture of cerebral autoregulation, the natural capacity to adjust cerebrovascular resistance to preserve cerebral blood flow in response to external stimuli. Cerebral autoregulation is often impaired in TBI patients, and monitoring cerebral autoregulation might be useful to develop personalized therapy rather than treatment of one size fits all thresholds and guidelines based on unidimensional static relationships. Today, there is no gold standard available to estimate cerebral autoregulation. Cerebral autoregulation can be triggered by performing a mean arterial pressure (MAP) challenge, in which MAP is increased by 10% for 20 min. The response of ICP (increase or decrease) will estimate the status of cerebral autoregulation and can steer therapy mainly concerning optimizing patient-specific CPP. The role of cerebral metabolic changes and its relationship to cerebral autoregulation is still unclear and awaits further investigation.

UI	MeSH Term	Description	Entries
D007427	Intracranial Pressure	Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity.	Intracerebral Pressure,Subarachnoid Pressure,Intracerebral Pressures,Intracranial Pressures,Pressure, Intracerebral,Pressure, Intracranial,Pressure, Subarachnoid,Pressures, Intracerebral,Pressures, Intracranial,Pressures, Subarachnoid,Subarachnoid Pressures
D001794	Blood Pressure	PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.	Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002560	Cerebrovascular Circulation	The circulation of blood through the BLOOD VESSELS of the BRAIN.	Brain Blood Flow,Regional Cerebral Blood Flow,Cerebral Blood Flow,Cerebral Circulation,Cerebral Perfusion Pressure,Circulation, Cerebrovascular,Blood Flow, Brain,Blood Flow, Cerebral,Brain Blood Flows,Cerebral Blood Flows,Cerebral Circulations,Cerebral Perfusion Pressures,Circulation, Cerebral,Flow, Brain Blood,Flow, Cerebral Blood,Perfusion Pressure, Cerebral,Pressure, Cerebral Perfusion
D006706	Homeostasis	The processes whereby the internal environment of an organism tends to remain balanced and stable.	Autoregulation
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070642	Brain Injuries, Traumatic	A form of acquired brain injury which occurs when a sudden trauma causes damage to the brain.	Trauma, Brain,Traumatic Brain Injury,Encephalopathy, Traumatic,Injury, Brain, Traumatic,TBI (Traumatic Brain Injury),TBIs (Traumatic Brain Injuries),Traumatic Encephalopathy,Brain Injury, Traumatic,Brain Trauma,Brain Traumas,Encephalopathies, Traumatic,TBI (Traumatic Brain Injuries),Traumas, Brain,Traumatic Brain Injuries,Traumatic Encephalopathies
D062186	Arterial Pressure	The blood pressure in the ARTERIES. It is commonly measured with a SPHYGMOMANOMETER on the upper arm which represents the arterial pressure in the BRACHIAL ARTERY.	Aortic Blood Pressure,Aortic Pressure,Aortic Pulse Pressure,Aortic Tension,Arterial Blood Pressure,Arterial Tension,Blood Pressure, Aortic,Blood Pressure, Arterial,Mean Aortic Pressure,Mean Arterial Pressure,Aortic Blood Pressures,Aortic Pressure, Mean,Aortic Pressures,Aortic Pressures, Mean,Aortic Pulse Pressures,Aortic Tensions,Arterial Blood Pressures,Arterial Pressure, Mean,Arterial Pressures,Arterial Pressures, Mean,Arterial Tensions,Blood Pressures, Aortic,Blood Pressures, Arterial,Mean Aortic Pressures,Mean Arterial Pressures,Pressure, Aortic,Pressure, Aortic Blood,Pressure, Aortic Pulse,Pressure, Arterial,Pressure, Arterial Blood,Pressure, Mean Aortic,Pressure, Mean Arterial,Pressures, Aortic,Pressures, Aortic Blood,Pressures, Aortic Pulse,Pressures, Arterial,Pressures, Arterial Blood,Pressures, Mean Aortic,Pressures, Mean Arterial,Pulse Pressure, Aortic,Pulse Pressures, Aortic,Tension, Aortic,Tension, Arterial,Tensions, Aortic,Tensions, Arterial