Continuous measurement in neurocritical care of cerebral blood flow (CBF) calculated from ICP and central venous pressure

Continuous measurement in neurocritical care of cerebral blood flow (CBF) calculated from ICP and central venous pressure | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Continuous measurement in neurocritical care of cerebral blood flow (CBF) calculated from ICP and central venous pressure Erik Ryding, Peter Reinstrup This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3953583/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 07 Oct, 2024 Read the published version in Scientific Reports → Version 1 posted 13 You are reading this latest preprint version Abstract The cerebral blood flow, CBF, is an important clinical parameter in neuro-intensive care. The possibility to continuously monitor CBF, computed from referential ICP (rICP, calculated from measured ICP and mean CVP) and venous outflow resistance, Rv, could importantly improve patient care. The theoretical background involves rICP (the venous perfusion pressure) and the pulsative part of CBF (with rICP increase due to vascular volume increase) which gives the venous outflow resistance, Rv. rICP divided with Rv then gives CBF. The parameters rICP, Rv and CBF were then calculated in the same way in nine subjects from measurements of ICP and of intracerebral venous volume increase. The result was two methods for continuous monitoring of CBF from rICP, one using the systolic ICP increase, and one using the relationship between Rv and rICP at rICP exceeding about 10 mmHg, The constant monitoring of rICP opens the possibility to constantly monitor CBF and other clinical parameters, like venous outflow resistance, and mean arteriolar sphincter resistance. Biological sciences/Neuroscience Health sciences/Medical research Health sciences/Neurology Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Full Text Additional Declarations No competing interests reported. Supplementary Files CalcContinuosCBF.xlsx Cite Share Download PDF Status: Published Journal Publication published 07 Oct, 2024 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 30 May, 2024 Reviews received at journal 29 May, 2024 Reviewers agreed at journal 09 May, 2024 Reviews received at journal 13 Apr, 2024 Reviewers agreed at journal 11 Apr, 2024 Reviews received at journal 05 Apr, 2024 Reviewers agreed at journal 05 Apr, 2024 Reviewers agreed at journal 22 Mar, 2024 Reviewers invited by journal 22 Mar, 2024 Editor assigned by journal 19 Mar, 2024 Editor invited by journal 21 Feb, 2024 Submission checks completed at journal 21 Feb, 2024 First submitted to journal 13 Feb, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3953583","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":274260986,"identity":"d07a8f9a-efe8-4ec0-94a9-c68190c9aff1","order_by":0,"name":"Erik Ryding","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAu0lEQVRIiWNgGAWjYFACxmaGD0CyjSQtjDMQWgyI0sPMzAPU0kC0Fn7pw83GtnsOy/ZJt19gLqj4Q1iLZF9ic3LOs8PGbTJnCphnnCHCFoMzjM2Hcw4cTmyTyElg5m0jQos9SIsFXMs/YmzhYWxOZgBrST/AzNtAhBYJoC2GPQfSjYG2MBzmOWZMWAt/D/tjiR8HrGXnz0h/+JinRo6wFihoBmIegwNEqweCOiBmf0CKjlEwCkbBKBhBAAApITfwXklpIQAAAABJRU5ErkJggg==","orcid":"","institution":"Skane University Hospital in Lund","correspondingAuthor":true,"prefix":"","firstName":"Erik","middleName":"","lastName":"Ryding","suffix":""},{"id":274260987,"identity":"b2a0ca2a-6c05-4183-a8c5-226497575906","order_by":1,"name":"Peter Reinstrup","email":"","orcid":"","institution":"Skane University Hospital in Lund","correspondingAuthor":false,"prefix":"","firstName":"Peter","middleName":"","lastName":"Reinstrup","suffix":""}],"badges":[],"createdAt":"2024-02-13 13:19:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3953583/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3953583/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-024-74983-4","type":"published","date":"2024-10-07T15:57:19+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":51563226,"identity":"5c4655f4-5711-4349-a8ad-9eebb33e2459","added_by":"auto","created_at":"2024-02-23 18:44:52","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":50171,"visible":true,"origin":"","legend":"\u003cp\u003eThe relationship between rICP and intracerebral volume in (Vin)\u003c/p\u003e\n\u003cp\u003eaccording to Formula [2].\u003c/p\u003e","description":"","filename":"ContCBFpict1.png","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/1e7722acc9a9998c7d05ad05.png"},{"id":51563228,"identity":"9f255403-4cdd-41e6-84b4-bc46ceb2b889","added_by":"auto","created_at":"2024-02-23 18:44:53","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":137561,"visible":true,"origin":"","legend":"\u003cp\u003eOne pulse cycle measurement of ICP (black line), and intracranial\u003c/p\u003e\n\u003cp\u003evenous volume increase (gray line), in ten subjects. From Unnerbäck8.\u003c/p\u003e","description":"","filename":"ContCBFpict2.png","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/59663b310d7024c26baea933.png"},{"id":51563227,"identity":"83aca3a4-400b-4119-9ed6-98eac512a5ec","added_by":"auto","created_at":"2024-02-23 18:44:53","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":210716,"visible":true,"origin":"","legend":"\u003cp\u003eMaximal fit of the intracranial venous volume increase (gray line)\u003c/p\u003e\n\u003cp\u003einto the ICP increase at systole gives estimate of d(rICP)/d(Vin). Data from\u003c/p\u003e\n\u003cp\u003efigure 2.\u003c/p\u003e","description":"","filename":"ContCBFpict3.png","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/c9a6c0aef21e5bbf32911c86.png"},{"id":51563230,"identity":"4db3c008-fa66-4dfb-b9f0-a571ada1c2fc","added_by":"auto","created_at":"2024-02-23 18:44:53","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":27643,"visible":true,"origin":"","legend":"\u003cp\u003ea/ The linear relationship, and b/ the logarithmic relationship\u003c/p\u003e\n\u003cp\u003ebetween rICP and the venous outflow resistance, Rv, and linear regression\u003c/p\u003e\n\u003cp\u003e(p\u0026lt;0,0001).\u003c/p\u003e","description":"","filename":"ContCBFpict4.png","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/6ea0b282f7525d466c7147ec.png"},{"id":51563231,"identity":"2a5b7e97-aac2-4506-b431-002cb323b673","added_by":"auto","created_at":"2024-02-23 18:44:53","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":62789,"visible":true,"origin":"","legend":"\u003cp\u003eThe relationship between the venous outflow resistance, Rv, and\u003c/p\u003e\n\u003cp\u003ereferential ICP, rICP, shown by the linear regression in Figure 3B. The\u003c/p\u003e\n\u003cp\u003estandard deviation (SD) of Rv was ± 4%.\u003c/p\u003e","description":"","filename":"ContCBFpict5.png","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/45c9ba7ef4ce72ef40fd7fbc.png"},{"id":51563233,"identity":"7602aef4-cd0b-4588-a022-7a056bf04cf1","added_by":"auto","created_at":"2024-02-23 18:44:53","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":64282,"visible":true,"origin":"","legend":"\u003cp\u003eThe relationship between the maximal CBF limit and referential\u003c/p\u003e\n\u003cp\u003eICP, rICP, as shown by the linear regression in Figure 3B. The standard\u003c/p\u003e\n\u003cp\u003edeviation (SD) of CBF max was ± 5,4%.\u003c/p\u003e","description":"","filename":"ContCBFpict6.png","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/52e8ab495db560f99dcc1b00.png"},{"id":51564001,"identity":"54d5f104-7527-4f2c-9504-c5df91dfb76f","added_by":"auto","created_at":"2024-02-23 18:52:53","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":27815,"visible":true,"origin":"","legend":"\u003cp\u003eThe comparison between supine mean ICP and mean rICP over\u003c/p\u003e\n\u003cp\u003ethe pulse cycle in the 9 subjects. In a/ two subjects (at 11 and 44 mmHg\u003c/p\u003e\n\u003cp\u003erICP) had much lower (less than half) ICP than rICP and were exclude from\u003c/p\u003e\n\u003cp\u003efurther comparison. In b/ logarithmic comparison indicates a p\u0026lt;0,002\u003c/p\u003e\n\u003cp\u003elinear regression to the identity line between ICP and rICP. CBF data from\u003c/p\u003e\n\u003cp\u003efigure 2.\u003c/p\u003e","description":"","filename":"ContCBFpict7.png","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/2b1d6adde6b63b66d78a2345.png"},{"id":66597099,"identity":"e26c660d-daae-4445-8e89-075756dea44c","added_by":"auto","created_at":"2024-10-14 16:07:11","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":574090,"visible":true,"origin":"","legend":"","description":"","filename":"Continuousmeasurementofcerebralbloodflow.New.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1_covered_b8282ed2-caee-45ba-979f-24d897759f10.pdf"},{"id":51564000,"identity":"b55e5a5e-668c-4454-ab88-c795bc59a608","added_by":"auto","created_at":"2024-02-23 18:52:53","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":305789,"visible":true,"origin":"","legend":"","description":"","filename":"CalcContinuosCBF.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-3953583/v1/d7a5f7d284f1ad12d6ab4fc7.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Continuous measurement in neurocritical care of cerebral blood flow (CBF) calculated from ICP and central venous pressure","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-3953583/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3953583/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"The cerebral blood flow, CBF, is an important clinical parameter in neuro-intensive care. The possibility to continuously monitor CBF, computed from referential ICP (rICP, calculated from measured ICP and mean CVP) and venous outflow resistance, Rv, could importantly improve patient care. The theoretical background involves rICP (the venous perfusion pressure) and the pulsative part of CBF (with rICP increase due to vascular volume increase) which gives the venous outflow resistance, Rv. rICP divided with Rv then gives CBF. The parameters rICP, Rv and CBF were then calculated in the same way in nine subjects from measurements of ICP and of intracerebral venous volume increase. 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