Volume 12 Supplement 2

28th International Symposium on Intensive Care and Emergency Medicine

Open Access

Brain trauma care targets analysis using a high-rate recording and computing network

  • H Mehdaoui1,
  • R Valentino1,
  • L Allart2,
  • D Zitouni2,
  • B Sarrazin1,
  • C Meunier1,
  • I Elzein1,
  • S Tissier1 and
  • P Ravaux2
Critical Care200812(Suppl 2):P121

https://doi.org/10.1186/cc6342

Published: 13 March 2008

Introduction

We analyze information on brain-injured patients' monitoring and care provided by a powerful information system.

Methods

We analyzed 543 hours on 11 patients, limited to 72 hours per patient when available: mean arterial pressure (MAP), intracranial pressure (ICP) and cerebral perfusion pressure (CPP) values were plotted against guideline thresholds, respectively 90 mmHg, 20 mmHg and 60 mmHg. The data were sampled every 2 seconds. Extraction was performed using a 3 teraflops supercomputer. We developed a method to detect periods of abnormal values.

Results

The calculated CPP and monitored CPP differed despite a good correlation (r = 0.91, P < 0.0001). Fifty-seven percent, 40% and 27% of the recorded MAP, ICP and CPP values reached thresholds. The time distributions of abnormal CPP, ICP and MAP values are detailed in Table 1: 51.7% of the MAP periods, 48.8% of the ICP periods, 51.8% of the calculated CPP were short episodes (<30 min). Mortality was associated with CPP < 60 (OR = 4.13 – logistic regression model, P < 0.0001) and inversely associated with MAP drops and IC hypertension episodes (OR 0.58 and 0.45, respectively). The mean time spent in each episode was higher in the NS group (76 ± 6 vs 48 ± 5 min). Caregivers' actions are perceptible on a CPP distribution chart.
Table 1

Detected abnormal episodes

 

CPP

ICP

MAP

5–15 min

53

42

58

15–30 min

25

41

60

30–60 min

17

27

44

60–120 min

6

18

26

>120 min

13

17

40

Conclusion

Monitoring artifacts should be better identified when monitoring-based targets are used to guide therapy. Computer-based data analysis shows evidence of frequent episodes requiring therapeutic actions according to published guidelines, assuming that multimodal monitoring is not limited to the three studied parameters. Caregivers need new tools for data management to provide a better quality of care.

Declarations

Acknowledgements

Project funded by the EC and Martinique country.

Authors’ Affiliations

(1)
Fort de France University Hospital
(2)
Lille 2 University

Copyright

© BioMed Central Ltd 2008

This article is published under license to BioMed Central Ltd.

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