Gustavo Frigieri, Thauan Leandro Gonçalves, Gabriela Nagai Ocamoto, Rodrigo de Ap Andrade, Bruno Cezar de Padua, Danilo Cardim
{"title":"Brain4care系统在颅内高压无创检测中的临床应用","authors":"Gustavo Frigieri, Thauan Leandro Gonçalves, Gabriela Nagai Ocamoto, Rodrigo de Ap Andrade, Bruno Cezar de Padua, Danilo Cardim","doi":"10.1007/s12028-025-02273-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Noninvasive methods for detecting intracranial hypertension (IH) are of growing importance in clinical settings. This study evaluates the clinical performance of the brain4care (B4C) System, which captures pulsatile cranial expansions that reveal a surrogate intracranial pressure (ICP) waveform and subsequently derives the P2/P1 ratio and time-to-peak (TTP) parameters to predict IH.</p><p><strong>Methods: </strong>This was a retrospective study conducted across multiple centers that included a total of 124 patients. Invasively monitored ICP and noninvasive B4C waveforms were recorded simultaneously from patients with acute brain injuries. Data were analyzed using specific cutoff values for the estimated P2/P1 ratio (ranging from 0.8 to 1.4) and TTP (at 0.3) to assess their diagnostic accuracy. Sensitivity and specificity for detecting IH (ICP > 20 mm Hg) were determined based on these metrics.</p><p><strong>Results: </strong>The estimated P2/P1 ratio demonstrated a sensitivity of 92% and specificity of 19% at a threshold of 0.8, indicating high sensitivity for ruling out IH. At a ratio of 1.4, the specificity improved to 90%, suggesting its effectiveness for assessing IH. For TTP, a threshold of 0.3 was identified as the optimal cutoff, offering a specificity of 92%.</p><p><strong>Conclusions: </strong>The B4C System provides a viable, noninvasive approach to assessing IH. The study underscores the clinical utility of the P2/P1 ratio and TTP in detecting and ruling out IH, offering a significant alternative to invasive ICP monitoring methods.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"628-635"},"PeriodicalIF":3.6000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436508/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical Performance of the Brain4care System for Noninvasive Detection of Intracranial Hypertension.\",\"authors\":\"Gustavo Frigieri, Thauan Leandro Gonçalves, Gabriela Nagai Ocamoto, Rodrigo de Ap Andrade, Bruno Cezar de Padua, Danilo Cardim\",\"doi\":\"10.1007/s12028-025-02273-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Noninvasive methods for detecting intracranial hypertension (IH) are of growing importance in clinical settings. This study evaluates the clinical performance of the brain4care (B4C) System, which captures pulsatile cranial expansions that reveal a surrogate intracranial pressure (ICP) waveform and subsequently derives the P2/P1 ratio and time-to-peak (TTP) parameters to predict IH.</p><p><strong>Methods: </strong>This was a retrospective study conducted across multiple centers that included a total of 124 patients. Invasively monitored ICP and noninvasive B4C waveforms were recorded simultaneously from patients with acute brain injuries. Data were analyzed using specific cutoff values for the estimated P2/P1 ratio (ranging from 0.8 to 1.4) and TTP (at 0.3) to assess their diagnostic accuracy. Sensitivity and specificity for detecting IH (ICP > 20 mm Hg) were determined based on these metrics.</p><p><strong>Results: </strong>The estimated P2/P1 ratio demonstrated a sensitivity of 92% and specificity of 19% at a threshold of 0.8, indicating high sensitivity for ruling out IH. At a ratio of 1.4, the specificity improved to 90%, suggesting its effectiveness for assessing IH. For TTP, a threshold of 0.3 was identified as the optimal cutoff, offering a specificity of 92%.</p><p><strong>Conclusions: </strong>The B4C System provides a viable, noninvasive approach to assessing IH. The study underscores the clinical utility of the P2/P1 ratio and TTP in detecting and ruling out IH, offering a significant alternative to invasive ICP monitoring methods.</p>\",\"PeriodicalId\":19118,\"journal\":{\"name\":\"Neurocritical Care\",\"volume\":\" \",\"pages\":\"628-635\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436508/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurocritical Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12028-025-02273-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/28 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurocritical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12028-025-02273-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:无创检测颅内高压(IH)的方法在临床环境中越来越重要。本研究评估了brain4care (B4C)系统的临床表现,该系统捕捉脉动性颅骨扩张,显示替代颅内压(ICP)波形,随后推导出P2/P1比和峰值时间(TTP)参数来预测IH。方法:这是一项跨多个中心进行的回顾性研究,共包括124名患者。同时记录急性脑损伤患者有创颅内压和无创颅内压波形。使用估计的P2/P1比率(范围从0.8到1.4)和TTP(0.3)的特定截止值分析数据,以评估其诊断准确性。根据这些指标确定检测IH (ICP > 20 mm Hg)的敏感性和特异性。结果:估计的P2/P1比值在0.8的阈值下敏感性为92%,特异性为19%,表明排除IH的敏感性很高。在比值为1.4时,特异性提高到90%,表明其评估IH的有效性。对于TTP,阈值0.3被确定为最佳临界值,特异性为92%。结论:B4C系统为评估IH提供了一种可行的、无创的方法。该研究强调了P2/P1比值和TTP在检测和排除IH方面的临床应用,为侵入性ICP监测方法提供了重要的替代方案。
Clinical Performance of the Brain4care System for Noninvasive Detection of Intracranial Hypertension.
Background: Noninvasive methods for detecting intracranial hypertension (IH) are of growing importance in clinical settings. This study evaluates the clinical performance of the brain4care (B4C) System, which captures pulsatile cranial expansions that reveal a surrogate intracranial pressure (ICP) waveform and subsequently derives the P2/P1 ratio and time-to-peak (TTP) parameters to predict IH.
Methods: This was a retrospective study conducted across multiple centers that included a total of 124 patients. Invasively monitored ICP and noninvasive B4C waveforms were recorded simultaneously from patients with acute brain injuries. Data were analyzed using specific cutoff values for the estimated P2/P1 ratio (ranging from 0.8 to 1.4) and TTP (at 0.3) to assess their diagnostic accuracy. Sensitivity and specificity for detecting IH (ICP > 20 mm Hg) were determined based on these metrics.
Results: The estimated P2/P1 ratio demonstrated a sensitivity of 92% and specificity of 19% at a threshold of 0.8, indicating high sensitivity for ruling out IH. At a ratio of 1.4, the specificity improved to 90%, suggesting its effectiveness for assessing IH. For TTP, a threshold of 0.3 was identified as the optimal cutoff, offering a specificity of 92%.
Conclusions: The B4C System provides a viable, noninvasive approach to assessing IH. The study underscores the clinical utility of the P2/P1 ratio and TTP in detecting and ruling out IH, offering a significant alternative to invasive ICP monitoring methods.
期刊介绍:
Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.