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Investigating the applicability of the compensatory reserve index for forecasting intracranial pressure events
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Pineda, Bianca. Investigating the applicability of the compensatory reserve index for forecasting intracranial pressure events. Retrieved from https://doi.org/doi:10.7282/T3GH9KX5

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TitleInvestigating the applicability of the compensatory reserve index for forecasting intracranial pressure events
NamePineda, Bianca (author); Craelius, Willliam (chair); Hacihaliloglu, Ilker (internal member); Kaplan, Hilton (internal member); Khan, John (internal member); Rutgers University; Graduate School - New Brunswick
Date Created2015
Other Date2015-10 (degree)
SubjectBiomedical Engineering, Brain--Wounds and injuries, Intracranial pressure
Extent1 online resource (xi, 45 p. : ill.)
DescriptionThere are about 1.7 million cases of traumatic brain injury in the U.S. annually. After injury, the body’s compensatory mechanisms cause fluid to accumulate in the cranium. This gives rise to elevated intracranial pressure (ICP) which then causes ischemia. To compensate for this, vessels dilate causing more fluid to build and the cycle to repeat. If left unchecked, this cycle compromises cerebral autoregulation such that the body cannot maintain stable ICP in response to changes in volume. This leads to intracranial hypertension and secondary injuries such as hemorrhaging, etc. In order to prevent secondary injury, the standard of care for patients with moderate to severe head injuries is to monitor their ICP in surgical intensive care units. However, treatments are only implemented after ICP has reached a critical value and noticeable damage has occurred. The goal of this project is to develop a method to forecast the occurrence of these critical events in ICP so that treatments can be applied preemptively. Working towards this goal, a numerical descriptor of cerebral autoregulation called the compensatory reserve index (RAP) was analyzed for its potential ability to forecast rises in ICP. Retrospective data was analyzed from two patients with TBI who were monitored for 38 and 340 hours, respectively. Hours were separated into either ‘stable’ or ‘unstable’ periods of ICP according to established rules and RAP calculated for each hour. Results showed that, 1) the cumulative distribution of RAP calculated in ‘stable’ ICP periods differs significantly from that in ‘unstable’ periods (p < 0.001), 2) in several instances of ICP elevation, RAP exceeded the set threshold in both patients with latency values normally between 1-3 minutes. Thus, the results support the hypothesis that RAP is significantly associated with hemodynamic instability and its potential as a predictor of the same.
NoteM.S.
NoteIncludes bibliographical references
Noteby Bianca Pineda
Genretheses, ETD graduate
Persistent URLhttps://doi.org/doi:10.7282/T3GH9KX5
Languageeng
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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