Citation

Svedung Wettervik T, Beqiri E, Smielewski P. Crit. Care 2023; 27(1): e452.

Copyright

(Copyright © 2023, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13054-023-04728-8

PMID

37986121

PMCID

PMC10662776

Abstract

We thank Taccone et al. for their important comments regarding our original article [1]. In this part I study, we explored the relation between global cerebral physiological variables (intracranial pressure [ICP], cerebral perfusion pressure [CPP], pressure reactivity index [PRx], and optimal CPP [CPPopt]) and brain tissue oxygenation (pbtO2) in traumatic brain injury (TBI).

We found that although the global cerebral physiological variables and pbtO2 were significantly related, these associations were weak in magnitude and were most pronounced in cases of extreme disturbances in global cerebral physiology. Notably, these findings were also evident in linear mixed effect models, in which we included patients as a random effect. This approach allowed us to account for patient heterogeneity in terms of differences in the proximity between focal lesions and the pbtO2 probe and slight changes in neurocritical care management over the long study period. The latter included approaches informed by both pbtO2 and PRx/CPPopt in the later years. Unfortunately, access to specific data on pbtO2 probe location and more granular details of pbtO2-directed management were not available for analysis. Thus, while we fully agree with Taccone et al. that such data would have refined our analyses, we feel that our statistical approach has lessened these effects somewhat by focusing on the within-patient relationships...

Language: en

Keywords

Humans; Brain; *Brain Injuries, Traumatic/therapy; *Oxygen