Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

A Novel Noninvasive Technique for Intracranial Pressure Waveform Monitoring in Critical Care

Version 1 : Received: 6 October 2021 / Approved: 7 October 2021 / Online: 7 October 2021 (10:54:26 CEST)

How to cite: Brasil, S.; Solla, D.; Nogueira, R.D.C.; Jacobsen Teixeira, M.; Malbouisson, L.M.S.; Paiva Silva, W. A Novel Noninvasive Technique for Intracranial Pressure Waveform Monitoring in Critical Care. Preprints 2021, 2021100115 (doi: 10.20944/preprints202110.0115.v1). Brasil, S.; Solla, D.; Nogueira, R.D.C.; Jacobsen Teixeira, M.; Malbouisson, L.M.S.; Paiva Silva, W. A Novel Noninvasive Technique for Intracranial Pressure Waveform Monitoring in Critical Care. Preprints 2021, 2021100115 (doi: 10.20944/preprints202110.0115.v1).

Abstract

We validated a new noninvasive tool (B4C) to assess intracranial pressure waveform (ICPW) morphology in a set of neurocritical patients, correlating the data with ICPW obtained from invasive catheter monitoring. Materials and Methods: Patients undergoing invasive intracranial pressure (ICP) monitoring were consecutively evaluated using the B4C sensor. Ultrasound-guided manual internal jugular vein (IJV) compression was performed to elevate ICP from the baseline. ICP values, amplitudes, and time intervals (P2/P1 ratio and time-to-peak [TTP]) between the ICP and B4C waveform peaks were analyzed. Results: Among 41 patients, the main causes for ICP monitoring included traumatic brain injury, subarachnoid hemorrhage, and stroke. Bland-Altman’s plot indicated agreement between the ICPW parameters obtained using both techniques. The strongest Pearson’s correlation for P2/P1 and TTP was observed among patients with no cranial damage (r = 0.72 and 0.85, respectively) in detriment of those who have undergone craniotomies or craniectomies. P2/P1 values of 1 were equivalent between the two techniques (area under the receiver operator curve [AUROC], 0.9) whereas B4C cut-off 1.2 was predictive of intracranial hypertension (AUROC 0.9, p < 000.1 for ICP > 20 mmHg). Conclusion: B4C provided biometric amplitude ratios correlated with ICPW variation morphology and is useful for noninvasive critical care monitoring.

Keywords

intracranial compliance; intracranial pressure; intracranial hypertension; acute brain injury

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