Autonomic Nervous System Activity during Refractory Rise in Intracranial Pressure. ...

Refractory intracranial hypertension (RIH) is a dramatic increase in intracranial pressure (ICP) that cannot be controlled by treatment. Recent reports suggest that the autonomic nervous system (ANS) activity may be altered during changes in ICP. Our study aimed to assess ANS activity during RIH and...

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Bibliographic Details
Main Authors: Fedriga, Marta, Czigler, Andras, Nasr, Nathalie, Zeiler, Frederick A, Park, Soojin, Donnelly, Joseph, Papaioannou, Vasilios, Frisvold, Shirin K, Wolf, Stephan, Rasulo, Frank, Sykora, Marek, Smielewski, Peter, Czosnyka, Marek
Format: Article in Journal/Newspaper
Language:English
Published: Mary Ann Liebert Inc 2021
Subjects:
Granger causality
autonomic nervous system
refractory intracranial hypertension
upper breakpoint of ICP
Adult
Aged
Autonomic Nervous System
Baroreflex
Brain Injuries
Female
Heart Rate
Humans
Intracranial Hypertension
Male
Middle Aged
Retrospective Studies
Tromso
Online Access:https://dx.doi.org/10.17863/cam.65695
https://www.repository.cam.ac.uk/handle/1810/318580
Description
Summary:Refractory intracranial hypertension (RIH) is a dramatic increase in intracranial pressure (ICP) that cannot be controlled by treatment. Recent reports suggest that the autonomic nervous system (ANS) activity may be altered during changes in ICP. Our study aimed to assess ANS activity during RIH and the causal relationship between rising in ICP and autonomic activity. We reviewed retrospectively 24 multicenter (Cambridge, Tromso, Berlin) patients in whom RIH developed as a pre-terminal event after acute brain injury (ABI). They were monitored with ICP, arterial blood pressure (ABP), and electrocardiography (ECG) using ICM+ software. Parameters reflecting autonomic activity were computed in time and frequency domain through the measurement of heart rate variability (HRV) and baroreflex sensitivity (BRS). Our results demonstrated that a rise in ICP was associated to a significant rise in HRV and BRS with a higher significance level in the high-frequency HRV (p < 0.001). This increase was followed by a ...

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