Age, intracranial pressure, autoregulation, and outcome after brain trauma.

Détails

ID Serval
serval:BIB_5E7E325A80DC
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Age, intracranial pressure, autoregulation, and outcome after brain trauma.
Périodique
Journal of Neurosurgery
Auteur(s)
Czosnyka M., Balestreri M., Steiner L., Smielewski P., Hutchinson P.J., Matta B., Pickard J.D.
ISSN
0022-3085
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
102
Numéro
3
Pages
450-454
Langue
anglais
Résumé
OBJECT: The object of this study was to investigate whether a failure of cerebrovascular autoregulation contributes to the relationship between age and outcome in patients following head injury. METHODS: Data obtained from continuous bedside monitoring of intracranial pressure (ICP), arterial blood pressure (ABP), and cerebral perfusion pressure (CPP = ABP - ICP) in 358 patients with head injuries and intermittent monitoring of transcranial Doppler blood flow velocity (FV) in the middle cerebral artery in 237 patients were analyzed retrospectively. Indices used to describe cerebral autoregulation and pressure reactivity were calculated as correlation coefficients between slow waves of systolic FV and CPP (autoregulation index [ARI]) and between ABP and ICP (pressure reactivity index [PRI]). Older patients had worse outcomes after brain trauma than younger patients (p = 0.00001), despite the fact that the older patients had higher initial Glasgow Coma Scale scores (p = 0.006). When age was considered as an independent variable, it appeared that ICP decreased with age (p = 0.005), resulting in an increasing mean CPP (p = 0.0005). Blood FV was not dependent on age (p = 0.58). Indices of autoregulation and pressure reactivity demonstrated a deterioration in cerebrovascular control with advancing age (PRI: p = 0.003; ARI: p = 0.007). CONCLUSIONS: An age-related decline in cerebrovascular autoregulation was associated with a relative deterioration in outcome in elderly patients following head trauma.
Mots-clé
Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Blood Flow Velocity, Brain Injuries/physiopathology, Cerebrovascular Circulation/physiology, Female, Homeostasis/physiology, Humans, Intracranial Pressure/physiology, Male, Middle Aged, Middle Cerebral Artery/physiopathology, Retrospective Studies
Pubmed
Web of science
Création de la notice
14/01/2010 17:47
Dernière modification de la notice
20/08/2019 15:16
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