Representation Learning for Cerebrovascular Autoregulation: A Model Study with Experimental Data Classification.

Objective: Cerebrovascular autoregulation (CA) maintains adequate cerebral blood flow (CBF) during changes in cerebral perfusion pressure (CPP) and can be dynamically altered after traumatic brain injury (TBI). A novel deep representation learning model was developed to dynamically monitor the CA state using concurrent time series of arterial blood pressure (ABP) and intracranial pressure (ICP). The latter model showed a significant increase in ABP and ICP reconstruction error concurrent with increases or decreases in CBF.

KidsBrainIT: Visualization of the Impact of Cerebral Perfusion Pressure Insult Intensity and Duration on Childhood Brain Trauma Outcome.

Background: Cerebral perfusion pressure (CPP) dose-response on post-traumatic brain injury (TBI) outcome in children remains unknown. This project aimed to produce the first pediatric post-TBI CPP dose-response visualization plot from the international multicenter KidsBrainIT data set.

Methods: Fully anonymized prospectively collected routine minute-by-minute intracranial pressure (ICP), mean arterial blood pressure, and CPP time series data from 104 pediatric patients with TBI were categorized into CPP intensity duration episodes, albeit CPP above or below a range of thresholds.

Visualizing the burden of brain tissue hypoxia and metabolic dysfunction assessed by multimodal neuromonitoring in subarachnoid hemorrhage patients: the TITAN study.

Purpose: Brain tissue hypoxia and metabolic dysfunction are common in patients with subarachnoid hemorrhage (SAH) and may worsen prognosis. We aimed to assess the impact of episodes of low brain tissue partial pressure of oxygen (PbtO) and metabolic dysfunction (elevated lactate pyruvate ratio-LPR measured by cerebral microdialysis, CMD) on neurological outcome at 6 months.

Methods: This is a multicentric retrospective cohort study of SAH patients admitted to 5 neurocritical care units who required invasive multimodal neuromonitoring.

The Influence of Different Arterial Carbon Dioxide Levels on the Cerebrovascular Autoregulation Curve in a Porcine Cranial Window Model.

Background: Cerebrovascular autoregulation (CA) is the ability to maintain adequate cerebral blood flow (CBF) over a wide range of arterial blood pressures (ABPs). Carbon dioxide (CO) is a potent vasodilator, but its precise influence on CA remains incompletely understood.

Methods: A porcine cranial window model, in which CBF can be measured directly in the pial arterioles while ABP is mechanically manipulated, is used to investigate the effect of partial pressure of CO in arterial blood (PaCO) on CA capacity.

Development of an Active Cerebrovascular Autoregulation Model Using Representation Learning: A Proof of Concept Study With Experimental Data.

Background And Objectives: It remains a challenge to monitor cerebrovascular autoregulation (CA) reliably and dynamically in an intensive care unit. The objective was to build a proof-of-concept active CA model exploiting advances in representation learning and the full complexity of the arterial blood pressure (ABP) and intracranial pressure (ICP) signal and outperform the pressure reactivity index (PRx).

Methods: A porcine cranial window CA data set (n = 20) was used.

The Pressure Reactivity Index as a Measure for Cerebrovascular Autoregulation: Validation in a Porcine Cranial Window Model.

Background And Objectives: Pressure reactivity index (PRx) has been proposed as a metric associated with cerebrovascular autoregulatory (CA) function and has been thoroughly investigated in clinical research. In this study, PRx is validated in a porcine cranial window model, developed to visualize pial arteriolar autoregulation and its limits.

Methods: We measured arterial blood pressure, intracranial pressure, pial arteriolar diameter, and red blood cell (RBC) velocity in a closed cranial window piglet model during gradual balloon catheter-induced arterial hypotension (n = 10) or hypertension (n = 10).

Visualization of the Intracranial Pressure and Time Burden in Childhood Brain Trauma: What We Have Learned One Decade on With KidsBrainIT.

To validate the intracranial pressure (ICP) dose-response visualization plot for the first time in a novel prospectively collected pediatric traumatic brain injury (pTBI) data set from the multi-center, multi-national KidsBrainIT consortium. Prospectively collected minute-by-minute ICP and mean arterial blood pressure time series of 104 pTBI patients were categorized in ICP intensity-duration episodes. These episodes were correlated with the 6-month Glasgow Outcome Score (GOS) and displayed in a color-coded ICP dose-response plot.