Model-based Indices Describing Cerebrovascular Dynamics
Georgios V Varsos , Magdalena Kasprowicz , Peter Smielewski , Marek Czosnyka
Abstractnderstanding the dynamic relationship between cerebral blood ﬂow (CBF) and the circulation of cerebrospinal ﬂuid (CSF) can facilitate management of cerebral pathologies. For this reason, various hydrody- namic models have been introduced in order to simulate the phenomena governing the interaction between CBF and CSF. The identiﬁcation of hydrodynamic models requires an array of signals as input, with the most common of them being arterial blood pressure, intracranial pressure, and cerebral blood ﬂow velocity; monitoring all of them is considered as a standard practice in neurointensive care. Based on these signals, physiological parameters like cerebrovascular resistance, compliances of cerebrovascular bed, and CSF space could then be estimated. Various secondary model-based indices describing cerebrovascular dynamics have been introduced, like the cerebral arterial time constant or critical closing pressure. This review presents model-derived indices that describe cerebrovas- cular phenomena, the nature of which is both physiological (carbon dioxide reactivity and arterial hypotension) and pathological (cerebral artery stenosis, intracranial hyper- tension, and cerebral vasospasm). In a neurointensive environment, real-time monitoring of a patient with these indices may be able to provide a detection of the onset of a cerebrovascular phenomenon, which could have otherwise been missed. This potentially ‘‘early warning’’ indicator may then prove to be important for the therapeutic man- agement of the patient.
|Journal series||Neurocritical Care, ISSN 1541-6933|
|Keywords in English||Cerebrovascular bed; Cerebral blood ﬂow; Cerebrospinal ﬂuid; Hydrodynamic models; Model-based indices; Mathematical modeling|
|Score|| = 30.0, 30-01-2020, ArticleFromJournal|
= 30.0, 30-01-2020, ArticleFromJournal
|Publication indicators||= 12; = 15; : 2013 = 1.372; : 2013 = 2.604 (2) - 2013=2.618 (5)|
* presented citation count is obtained through Internet information analysis and it is close to the number calculated by the Publish or Perish system.