Ana Flávia Silveira, Marcella Barreto Santos, Nelci Zanon Collange, Cintya Yukie Hayashi, Gustavo Henrique Frigieri Vilela, Samantha Longhi Simões de Almeida, João Brainer Clares de Andrade, Salómon Rojas, Fabiano Moulin de Moraes, Viviane Cordeiro Veiga, Uri Adrian Prync Flato, Thiago Luiz Russo, Gisele Sampaio Silva
{"title":"COVID-19 患者的颅内顺应性：一项多中心观察研究。","authors":"Ana Flávia Silveira, Marcella Barreto Santos, Nelci Zanon Collange, Cintya Yukie Hayashi, Gustavo Henrique Frigieri Vilela, Samantha Longhi Simões de Almeida, João Brainer Clares de Andrade, Salómon Rojas, Fabiano Moulin de Moraes, Viviane Cordeiro Veiga, Uri Adrian Prync Flato, Thiago Luiz Russo, Gisele Sampaio Silva","doi":"10.1055/s-0044-1788669","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong> Patients with severe coronavirus disease-19 (COVID-19) may require the use of invasive mechanical ventilation (MV) for prolonged periods. Aggressive MV parameters have been associated with changes in intracranial pressure (ICP) in patients with acute intracranial disorders. Significant ICP elevation could compromise intracranial compliance (ICC) and cerebrovascular hemodynamics (CVH). However, the effects of these parameters in individuals without neurological disorders have not yet been evaluated.</p><p><strong>Objective: </strong> To evaluate ICC in patients on MV with COVID-19 infection compared to other diagnoses, to better characterize the effects of MV and COVID-19 upon ICC. We also compared between the ICC in patients with COVID-19 who did not require MV and healthy volunteers, to assess the isolated effect of COVID-19 upon ICC.</p><p><strong>Methods: </strong> This was an exploratory, observational study with a convenience sample. The ICC was evaluated with a noninvasive ICP monitoring device. The P2/P1 ratio was calculated by dividing the amplitude of these two points, being defined as \"abnormal\" when P2 > P1. The statistical analysis was performed using a mixed linear model with random effects to compare the P2/P1 ratio in all four groups on the first monitoring day.</p><p><strong>Results: </strong> A convenience sample of 78 subjects (15 MV-COVID-19, 15 MV non-COVID-19, 24 non-MV-COVID-19, and 24 healthy participants) was prospectively enrolled. There was no difference in P2/P1 ratios between MV patients with and without COVID-19, nor between non-MV patients with COVID-19 and healthy volunteers. However, the P2/P1 ratio was higher in COVID-19 patients with MV use than in those without it.</p><p><strong>Conclusion: </strong> This exploratory analysis suggests that COVID-19 does not impair ICC.</p>","PeriodicalId":8694,"journal":{"name":"Arquivos de neuro-psiquiatria","volume":"82 9","pages":"1-8"},"PeriodicalIF":1.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Intracranial compliance in patients with COVID-19: a multicenter observational study.\",\"authors\":\"Ana Flávia Silveira, Marcella Barreto Santos, Nelci Zanon Collange, Cintya Yukie Hayashi, Gustavo Henrique Frigieri Vilela, Samantha Longhi Simões de Almeida, João Brainer Clares de Andrade, Salómon Rojas, Fabiano Moulin de Moraes, Viviane Cordeiro Veiga, Uri Adrian Prync Flato, Thiago Luiz Russo, Gisele Sampaio Silva\",\"doi\":\"10.1055/s-0044-1788669\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong> Patients with severe coronavirus disease-19 (COVID-19) may require the use of invasive mechanical ventilation (MV) for prolonged periods. Aggressive MV parameters have been associated with changes in intracranial pressure (ICP) in patients with acute intracranial disorders. Significant ICP elevation could compromise intracranial compliance (ICC) and cerebrovascular hemodynamics (CVH). However, the effects of these parameters in individuals without neurological disorders have not yet been evaluated.</p><p><strong>Objective: </strong> To evaluate ICC in patients on MV with COVID-19 infection compared to other diagnoses, to better characterize the effects of MV and COVID-19 upon ICC. We also compared between the ICC in patients with COVID-19 who did not require MV and healthy volunteers, to assess the isolated effect of COVID-19 upon ICC.</p><p><strong>Methods: </strong> This was an exploratory, observational study with a convenience sample. The ICC was evaluated with a noninvasive ICP monitoring device. The P2/P1 ratio was calculated by dividing the amplitude of these two points, being defined as \\\"abnormal\\\" when P2 > P1. The statistical analysis was performed using a mixed linear model with random effects to compare the P2/P1 ratio in all four groups on the first monitoring day.</p><p><strong>Results: </strong> A convenience sample of 78 subjects (15 MV-COVID-19, 15 MV non-COVID-19, 24 non-MV-COVID-19, and 24 healthy participants) was prospectively enrolled. There was no difference in P2/P1 ratios between MV patients with and without COVID-19, nor between non-MV patients with COVID-19 and healthy volunteers. 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Intracranial compliance in patients with COVID-19: a multicenter observational study.
Background: Patients with severe coronavirus disease-19 (COVID-19) may require the use of invasive mechanical ventilation (MV) for prolonged periods. Aggressive MV parameters have been associated with changes in intracranial pressure (ICP) in patients with acute intracranial disorders. Significant ICP elevation could compromise intracranial compliance (ICC) and cerebrovascular hemodynamics (CVH). However, the effects of these parameters in individuals without neurological disorders have not yet been evaluated.
Objective: To evaluate ICC in patients on MV with COVID-19 infection compared to other diagnoses, to better characterize the effects of MV and COVID-19 upon ICC. We also compared between the ICC in patients with COVID-19 who did not require MV and healthy volunteers, to assess the isolated effect of COVID-19 upon ICC.
Methods: This was an exploratory, observational study with a convenience sample. The ICC was evaluated with a noninvasive ICP monitoring device. The P2/P1 ratio was calculated by dividing the amplitude of these two points, being defined as "abnormal" when P2 > P1. The statistical analysis was performed using a mixed linear model with random effects to compare the P2/P1 ratio in all four groups on the first monitoring day.
Results: A convenience sample of 78 subjects (15 MV-COVID-19, 15 MV non-COVID-19, 24 non-MV-COVID-19, and 24 healthy participants) was prospectively enrolled. There was no difference in P2/P1 ratios between MV patients with and without COVID-19, nor between non-MV patients with COVID-19 and healthy volunteers. However, the P2/P1 ratio was higher in COVID-19 patients with MV use than in those without it.
Conclusion: This exploratory analysis suggests that COVID-19 does not impair ICC.
期刊介绍：
Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology.
The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.
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