Effect of postural changes on ICP in healthy and ill subjects
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Effect of postural changes on ICP in healthy and ill subjects. / Petersen, Lonnie G; Juhler, Marianne.
I: Acta Neurochirurgica, Bind 157, Nr. 1, 01.2015, s. 109-13.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › fagfællebedømt
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TY - JOUR
T1 - Effect of postural changes on ICP in healthy and ill subjects
AU - Petersen, Lonnie G
AU - Juhler, Marianne
PY - 2015/1
Y1 - 2015/1
N2 - BACKGROUND: Reference values and physiological measurements of intracranial pressure (ICP) are primarily reported in the supine position, while reports of ICP in the vertical position are surprisingly rare considering that humans maintain the vertical position for the majority of the day. In order to distinguish normal human physiology from disease entities such as idiopathic intracranial hypertension and normal pressure hydrocephalus, we investigated ICP in different body postures in both normal and ill subjects.METHODS: Thirty-one patients were included: four normal patients following complete removal of a solitary clearly demarcated small brain tumour and fitted with a telemetric ICP monitoring device for long-term ICP monitoring; 27 patients requiring invasive ICP monitoring as a part of their diagnostic work-up or monitoring of shunt treatment effect. ICP was recorded in the following body positions: upright standing, sitting in a chair, supine and right lateral lumbar puncture position.RESULTS: Linear regression of median ICP based on patient posture, group, and purpose of monitoring presented a significant model (p < 0.001), but could not distinguish between patient groups (p = 0.88). Regression of differences in median ICP between body postures and supine ICP as the baseline, presented a highly significant model (p < 0.001) and adjusted R (2) = 0.86. Both body posture (p < 0.001) and patient group (p < 0.001) were highly significant factors.CONCLUSIONS: Differences in ICP between body postures enabled us to distinguish the normal group from patient groups. Normal patients appear able to more tightly regulate ICP when switching body postures.
AB - BACKGROUND: Reference values and physiological measurements of intracranial pressure (ICP) are primarily reported in the supine position, while reports of ICP in the vertical position are surprisingly rare considering that humans maintain the vertical position for the majority of the day. In order to distinguish normal human physiology from disease entities such as idiopathic intracranial hypertension and normal pressure hydrocephalus, we investigated ICP in different body postures in both normal and ill subjects.METHODS: Thirty-one patients were included: four normal patients following complete removal of a solitary clearly demarcated small brain tumour and fitted with a telemetric ICP monitoring device for long-term ICP monitoring; 27 patients requiring invasive ICP monitoring as a part of their diagnostic work-up or monitoring of shunt treatment effect. ICP was recorded in the following body positions: upright standing, sitting in a chair, supine and right lateral lumbar puncture position.RESULTS: Linear regression of median ICP based on patient posture, group, and purpose of monitoring presented a significant model (p < 0.001), but could not distinguish between patient groups (p = 0.88). Regression of differences in median ICP between body postures and supine ICP as the baseline, presented a highly significant model (p < 0.001) and adjusted R (2) = 0.86. Both body posture (p < 0.001) and patient group (p < 0.001) were highly significant factors.CONCLUSIONS: Differences in ICP between body postures enabled us to distinguish the normal group from patient groups. Normal patients appear able to more tightly regulate ICP when switching body postures.
KW - Adolescent
KW - Adult
KW - Aged
KW - Case-Control Studies
KW - Cerebrospinal Fluid Pressure
KW - Child
KW - Female
KW - Humans
KW - Hydrocephalus, Normal Pressure
KW - Intracranial Hypertension
KW - Intracranial Pressure
KW - Male
KW - Middle Aged
KW - Posture
U2 - 10.1007/s00701-014-2250-2
DO - 10.1007/s00701-014-2250-2
M3 - Journal article
C2 - 25307778
VL - 157
SP - 109
EP - 113
JO - Acta Neurochirurgica
JF - Acta Neurochirurgica
SN - 0001-6268
IS - 1
ER -
ID: 144450450