Article
Critical Care Medicine
Jennifer C. Laws, E. Haley Vance, Kristina A. Betters, Jessica J. Anderson, Sydney Fleishman, Christopher M. Bonfield, John C. Wellons III, Meng Xu, James C. Slaughter, Dario A. Giuse, Neal Patel, Lori C. Jordan, Michael S. Wolf
Summary: This retrospective observational study assessed the acute effects of ketamine on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in children with severe traumatic brain injury (TBI). The results showed that ketamine reduced ICP during ICP crises, but had no significant effect when used for sedation. These findings suggest that ketamine may be considered as a treatment for intracranial hypertension in children with severe TBI.
CRITICAL CARE MEDICINE
(2023)
Article
Health Care Sciences & Services
Sergio Brasil, Davi Jorge Fontoura Solla, Ricardo de Carvalho Nogueira, Manoel Jacobsen Teixeira, Luiz Marcelo Sa Malbouisson, Wellingson da Silva Paiva
Summary: A new noninvasive tool, B4C, was validated to assess intracranial pressure waveform morphology in neurocritical patients and correlated with invasive catheter monitoring. The study showed that B4C provided biometric amplitude ratios correlated with ICPW variation morphology and is useful for noninvasive critical care monitoring.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Neurosciences
Sergio Brasil, Fabio Silvio Taccone, Samia Yasin Wayhs, Bruno Martins Tomazini, Filippo Annoni, Sergio Fonseca, Estevao Bassi, Bruno Lucena, Ricardo De Carvalho Nogueira, Marcelo De-Lima-Oliveira, Edson Bor-Seng-Shu, Wellingson Paiva, Alexis Fournier Turgeon, Manoel Jacobsen Teixeira, Luiz Marcelo Sa Malbouisson
Summary: This study found that impairment of ICC and disturbances in CVH are common in severe COVID-19 cases and can accurately predict early adverse outcomes.
Review
Critical Care Medicine
Daniel Agustin Godoy, Sergio Brasil, Corrado Iaccarino, Wellingson Paiva, Andres M. Rubiano
Summary: For decades, the management of severe acute brain injury has focused on controlling intracranial hypertension (IH). However, the thresholds for determining IH have changed over time without clear evidence. Recent developments in understanding intracranial content dynamics and monitoring techniques suggest that targeting intracranial compliance (ICC) may be a more reliable approach. This perspective review discusses the concept of intracranial compartmental syndrome (ICCS) and proposes an integrative model for assessing IH and ICC using modern invasive and noninvasive techniques.
Article
Engineering, Biomedical
Yunyun Liang, Pei Mo, Xinguang Yang, Yihua He, Weijin Zhang, Xianfan Zeng, Longchang Xie, Qingchun Gao
Summary: This study compared the estimation of cerebral critical closing pressure and resistance-area product using blood pressure measurements from the common carotid artery and radial artery, and found that the values obtained from both methods were consistent.
MEDICAL ENGINEERING & PHYSICS
(2022)
Article
Clinical Neurology
Mais N. Al-Kawaz, Yunke Li, Richard E. Thompson, Radhika Avadhani, Adam de Havenon, Joshua Gruber, Issam Awad, Daniel F. Hanley, Wendy Ziai
Summary: The study demonstrated that surgical reduction of intracerebral hemorrhage volume through minimally invasive surgery (MIS) significantly reduced the proportion of high intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) events, which were associated with short- and long-term mortality.
FRONTIERS IN NEUROLOGY
(2021)
Article
Physiology
Sergio Brasil, Ricardo C. Nogueira, Angela S. M. Salinet, Marcia H. Yoshikawa, Manoel J. Teixeira, Wellingson Paiva, Luiz M. S. Malbouisson, Edson Bor-Seng-Shu, Ronney B. Panerai
Summary: This study found that in patients with acute brain injury, intracranial pressure (ICP) contributes less to cerebral blood flow autoregulation compared to mean arterial blood pressure (MAP). This has implications for the management of arterial blood pressure in neurocritical patients.
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY
(2023)
Article
Critical Care Medicine
Tommaso Zoerle, Tatiana Birg, Marco Carbonara, Peter Smielewski, Michal M. Placek, Elisa R. Zanier, Cecilia A. I. Akerlund, Fabrizio Ortolano, Nino A. Stocchetti
Summary: This study aimed to evaluate the accuracy of manual data annotation for capturing ICP and CPP, and found that manual recording underestimated the changes in ICP and CPP compared to a computerized system.
NEUROCRITICAL CARE
(2023)
Article
Clinical Neurology
Jiayi Zhong, Wanrong Lin, Junru Chen, Qingchun Gao
Summary: This study investigated the association between cerebral hemodynamic parameters and EPVS. The results showed a positive correlation between CCP and BG-EPVS, while no significant association was found between CCP and CSO-EPVS.
FRONTIERS IN NEUROLOGY
(2023)
Article
Surgery
Hossam Abdou, Joseph Edwards, Neerav Patel, David P. Stonko, Noha Elansary, Eric Lang, Michael J. Richmond, Thomas Ptak, Joseph M. White, Thomas M. Scalea, Jonathan J. Morrison
Summary: This study successfully established a titratable intracranial pressure model by using a Fogarty balloon catheter to increase intracranial pressure in an animal model, and measured the resulting decrease in brain perfusion.
JOURNAL OF SURGICAL RESEARCH
(2022)
Review
Critical Care Medicine
Sofie Dietvorst, Bart Depreitere, Geert Meyfroidt
Summary: This review emphasizes the importance of monitoring intracranial pressure (ICP) in severe traumatic brain injury (TBI) patients and the need to consider cerebral autoregulation in treatment decisions. It suggests that a mean arterial pressure (MAP) challenge can be used to evaluate cerebral autoregulation and guide personalized therapy for optimizing cerebral perfusion pressure (CPP). However, more research is needed to understand the relationship between cerebral metabolic changes and cerebral autoregulation.
CURRENT OPINION IN CRITICAL CARE
(2023)
Article
Anesthesiology
Swarna Rajagopalan, Jovany Cruz Navarro, Sanam Baghshomali, Matthew Kirschen, David Greer, W. Andrew Kofke, Ramani Balu
Summary: This study retrospectively observed the changes in cerebrovascular physiology and neurochemistry during brain death, finding that brain tissue undergoes significant alterations during brain death, which can be monitored and analyzed through intracranial neuromonitoring.
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
(2021)
Review
Critical Care Medicine
Daniel Agustin Godoy, Chiara Robba, Wellingson Silva Paiva, Alejandro A. Rabinstein
Summary: Pregnancy can lead to neurological complications, including intracranial hemorrhage, but there is a lack of research on the efficacy and safety of treatments for elevated intracranial pressure in pregnant patients, raising concerns for both the mother and the fetus.
NEUROCRITICAL CARE
(2022)
Article
Critical Care Medicine
Tatiana Birg, Fabrizio Ortolano, Eveline J. A. Wiegers, Peter Smielewski, Yan Savchenko, Bogdan A. Ianosi, Raimund Helbok, Sandra Rossi, Marco Carbonara, Tommaso Zoerle, Nino Stocchetti
Summary: Fever is frequent after traumatic brain injury (TBI), and it may influence brain physiology by affecting intracranial pressure (ICP) and cerebral perfusion pressure (CPP). A study revealed an association between brain temperature (BT) exceeding 37.5 degrees Celsius and higher ICP levels, but not for lower BT ranges. Rapid temperature changes seem to have a significant impact on ICP and CPP.
NEUROCRITICAL CARE
(2021)
Article
Anesthesiology
Dawei Zhou, Tong Li, Shuyang Fei, Chao Wang, Yi Lv
Summary: This study investigated the effect of positive end-expiratory pressure (PEEP) on intracranial pressure (ICP) in obese patients with severe brain injury (SBI). The results showed that PEEP was associated with an increase in ICP in obese SBI patients, but not in non-obese ones. However, the effect was modest and may not have significant clinical implications.
BMC ANESTHESIOLOGY
(2022)
Review
Endocrinology & Metabolism
Ronney B. Panerai, Patrice Brassard, Joel S. Burma, Pedro Castro, Jurgen A. H. R. Claassen, Johannes J. van Lieshout, Jia Liu, Samuel Je Lucas, Jatinder S. Minhas, Georgios D. Mitsis, Ricardo C. Nogueira, Shigehiko Ogoh, Stephen J. Payne, Caroline A. Rickards, Andrew D. Robertson, Gabriel D. Rodrigues, Jonathan D. Smirl, David M. Simpson
Summary: This study improved the evaluation method of cerebral autoregulation (CA) by introducing guidelines for data acquisition, analysis, and reporting, and proposed new recommendations to reflect recent advances in the field. The implementation of these recommendations is crucial for improving the reliability and reproducibility of studies.
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
(2023)
Article
Physiology
Sergio Brasil, Ricardo C. Nogueira, Angela S. M. Salinet, Marcia H. Yoshikawa, Manoel J. Teixeira, Wellingson Paiva, Luiz M. S. Malbouisson, Edson Bor-Seng-Shu, Ronney B. Panerai
Summary: This study found that in patients with acute brain injury, intracranial pressure (ICP) contributes less to cerebral blood flow autoregulation compared to mean arterial blood pressure (MAP). This has implications for the management of arterial blood pressure in neurocritical patients.
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY
(2023)
Article
Endocrinology & Metabolism
Daniel S. Abadjiev, Edgar Toschi-Dias, Angela S. M. Salinet, Nicole N. Gaykova, Men-Tzung Lo, Ricardo C. Nogueira, Kun Hu
Summary: A daily rhythm of dynamic cerebral autoregulation was observed in stroke patients, with better regulation of cerebral blood flow velocity in the afternoon. This finding may have implications for daily activity management in stroke patients.
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
(2023)
Review
Medicine, Research & Experimental
Wellingson Silva Paiva, Emanuele Zippo, Carolina Miranda, Sergio Brasil, Daniel Augustin Godoy, Almir Ferreira De Andrade, Iuri Neville, Gustavo Cartaxo Patriota, Renan Domingues, Manoel Jacobsen Teixeira
Summary: Intracranial hematomas (ICH) are a common condition in neurosurgical and neurological practices, and experimental research has played a fundamental role in understanding the pathophysiology and developing therapeutic interventions. Various animal models have been used to study ICH, including autologous blood or bacterial collagenase injection, inflation of intracranial balloon, and avulsion of cerebral vessels. These models have improved our understanding of intracranial hypertension, neuroinflammation, immunology, and brain hemodynamics, and have contributed to the development of therapeutic strategies.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2023)
Article
Anesthesiology
Sergio Brasil, Gustavo Frigieri, Fabio Silvio Taccone, Chiara Robba, Davi Jorge Fontoura Solla, Ricardo de Carvalho Nogueira, Marcia Harumy Yoshikawa, Manoel Jacobsen Teixeira, Luiz Marcelo Sa Malbouisson, Wellingson Silva Paiva
Summary: This study assessed the correlation between noninvasive intracranial pressure waveforms (NICPW) and invasively measured intracranial pressure (ICP), as well as the prognostic value of NICPW in acute brain-injured patients. The results showed a significant correlation between NICPW and ICP, and the NICPW-derived P2/P1 ratio could predict intracranial hypertension and early death.
JOURNAL OF CLINICAL MONITORING AND COMPUTING
(2023)
Editorial Material
Endocrinology & Metabolism
Sergio Brasil, Ronney B. Panerai, Edson Bor-Seng-Shu, Ricardo C. Nogueira
Summary: Cerebral perfusion pressure (CPP), which is commonly used in neurocritical care, is calculated as the difference between mean arterial blood pressure and mean intracranial pressure. This commentary discusses recent physiological advances and bedside practice issues, suggesting that considering CPP under this perspective may lead to inaccurate assumptions and potentially misleading decision making.
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
(2023)
Letter
Critical Care Medicine
Sergio Brasil, Juliana Caldas, Lucy Beishon, Jatinder S. Minhas, Ricardo C. Nogueira
NEUROCRITICAL CARE
(2023)
Article
Critical Care Medicine
Sergio Brasil, Hannah Romeijn, Esther K. Haspels, Wellingson Paiva, Arjen Schaafsma
Summary: This study compares the predictive value of the pulsatile apparent resistance (PaR) index versus the pulsatility index (PI) for intracranial hypertension (ICP > 20 mm Hg) in patients with traumatic brain injury. The results show that the discriminative power of PaR for discriminating intracranial hypertension was superior to PI. PaR seems to be a reliable noninvasive parameter for detecting intracranial hypertension.
NEUROCRITICAL CARE
(2023)
Article
Clinical Neurology
Sergio Brasil, Daniel A. Godoy, Wellingson S. Paiva
Summary: Based on recent research, intracranial pressure management based on predetermined thresholds is not accurate, and physicians need to combine other neuromonitoring techniques to comprehensively evaluate patients' neurological conditions.
WORLD NEUROSURGERY
(2023)
Letter
Clinical Neurology
Sergio Brasil, Daniel Agustin Godoy
ACTA NEUROCHIRURGICA
(2023)
Review
Critical Care Medicine
Daniel Agustin Godoy, Sergio Brasil, Corrado Iaccarino, Wellingson Paiva, Andres M. Rubiano
Summary: For decades, the management of severe acute brain injury has focused on controlling intracranial hypertension (IH). However, the thresholds for determining IH have changed over time without clear evidence. Recent developments in understanding intracranial content dynamics and monitoring techniques suggest that targeting intracranial compliance (ICC) may be a more reliable approach. This perspective review discusses the concept of intracranial compartmental syndrome (ICCS) and proposes an integrative model for assessing IH and ICC using modern invasive and noninvasive techniques.
Meeting Abstract
Critical Care Medicine
Sergio Brasil, Fabio Taccone
CRITICAL CARE MEDICINE
(2023)
Meeting Abstract
Critical Care Medicine
Sergio Brasil, Gustavo Frigieri, Chiara Robba, Fabio Taccone
CRITICAL CARE MEDICINE
(2023)