Investigating Cerebral Autoregulation in Traumatic Brain Injury via Simultaneous Measurements of Intracranial Pressure, Arterial Blood Pressure and relative Cerebral Blood Flow

Abstract

Traumatic Brain Injury (TBI) can alter the brains ability to maintain an adequate supply of oxygen and metabolites to brain tissue by disrupting the autoregulatory mechanisms that maintain constant cerebral blood flow. Impaired cerebral autoregulation can result in brain hypoxia leading to morbidity and mortality so maintenance of cerebral blood flow after injury is of paramount importance. Currently, this is managed using limited information and various assumptions, hence there is significant interest in developing better correlates for establishing whether cerebral autoregulation is impaired or intact. In this study we simultaneously measure cerebral blood flow (CBF) using a non-invasive optical approach, intracranial pressure (ICP, measured invasively) and arterial blood pressure (ABP) with the aim of investigating the relationships between these signals over multiple timescales, and ultimately assessing how these measurements may best be combined and interpreted to aid the treatment of TBI.