This paper describes and validates a new Cumulative Pressure-Time Index (CPT) which takes into account both duration and degree of cerebral perfusion pressure (CPP) derangement and determines critical thresholds for CPP, in a paediatric head injury dataset.
Sixty-six head-injured children, with invasive minute-to-minute intracranial pressure (ICP) and blood pressure monitoring, had their pre-set CPP derangement episodes (outside the normal range) identified in three childhood age-bands (2-6, 7-10, and 11-16 years) and global outcome assessed at six months post injury.
The new cumulative pressure-time index more accurately predicted outcome than previously used summary measures and by varying the threshold CPP values, it was found that these physiological threshold values (a48,a52 anda56 mmHg for 2-6, 7-10, and 11-16 years respectively) best predicted brain insult in terms of subsequent mortality and morbidity.
Jones PA, Chambers IR, Lo TYM, Andrews PJD, Chaudhry W, Clark A, Croft J, Forsyth R, Fulton B, Mendelow AD, Wilson G, Minns RA. Quantification of secondary CPP insult severity in paediatric head injured patients using a pressure-time index. Acta Neurochir (2005) [Suppl] 95: 29-32 6.
Dr. Iain R. Chambers, Cleveland Unit, Middlesbrough. Tel: +44 (0)1642-854-778.
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