Accepted for/Published in: JMIR Medical Informatics
Date Submitted: Aug 4, 2020
Date Accepted: Jan 22, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Model-based intra-cranial pressure estimation: toward a practical tool for clinical decision support at multi-hour timescales
ABSTRACT
Background:
Non-invasive intracranial pressure (nICP) estimation is a desirable tool for clinical decision support and improving outcomes for patients with traumatic brain injury (TBI).
Objective:
Existing model-based nICP estimation methods, however, may be too slow or require data not easily obtained. This work considers nICP estimation frameworks driven by arterial blood pressure (ABP) measurements to better inform model development toward clinically-actionable timescales.
Methods:
Two types of model setup are tested and validated at multi-hour timescales to assess the benefits and limitations of applying each at long time periods.
Results:
Over hour-scale times with pulsatile ABP inflow, a simple estimation scheme which include systemic hemodynamic feedback outperforms a more complex nICP model with prescribed intracranial inflow, even under limited ABP data resolution. This indicates that feedback between the systemic vascular network and nICP estimation scheme is crucial to include when modeling over long intervals. We also show that the simple estimation data requirements can be reduced to one-minute averaged ABP summary data under generic waveform representation, but reduction of ABP-only dependence limits its utility in cases involving other brain injuries such as ischemic stroke and subarachnoid hemorrhage
Conclusions:
This indicates that feedback between the systemic vascular network and nICP estimation scheme is crucial to include when modeling over long intervals. We also show that the simple estimation data requirements can be reduced to one-minute averaged ABP summary data under generic waveform representation, but reduction of ABP-only dependence limits its utility in cases involving other brain injuries such as ischemic stroke and subarachnoid hemorrhage.
Citation
The author of this paper has made a PDF available, but requires the user to login, or create an account.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.