Blood pressure in head-injured patients. Issue 4 (30th November 2006)

• Record Type: Journal Article
• Authors: Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 78:Issue 4(2007)
• Page Start: 399
• Page End: 402
• Publication Date: 2006-11-30
• Subjects: BP, blood pressure -- CPP, cerebral perfusion pressure -- ICP, intercranial pressure; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2006.100172
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objective: To determine the statistical characteristics of blood pressure (BP) readings from a large number of head-injured patients. Methods: The BrainIT group has collected high time-resolution physiological and clinical data from head-injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. Results: The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. Conclusions: Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic.