Intracranial Compliance, Resistance to CSF-Outflow, and Pressure-Volume Index in Hydrocephalus Patients: A Systematic Review and Meta-Analysis

IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Irbm Pub Date : 2023-10-01 DOI:10.1016/j.irbm.2023.100785
Seifollah Gholampour , Amber Nguyen , Saad Chaudry
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引用次数: 1

Abstract

Objectives

How changes in intracranial compliance (ICC), resistance to cerebrospinal fluid (CSF)-outflow (Rout), and pressure-volume index (PVI) can play a prominent role in clarifying the complexities in the biomechanism and treatment outcomes of hydrocephalus. This study aims to provide a comprehensive review to find the correlation between ICC, Rout, and PVI with intracranial pressure (ICP) characteristics, as well as morphometric parameters, in hydrocephalus patients.

Material and methods

Electronic searches were conducted using the PubMed/MEDLINE, Scopus, Google Scholar, Ovid, Cochrane, and EMBASE databases from their dates of inception to December 2022 using filters for English-language articles. The article selection and data collection were conducted in accordance with PRISMA guidelines and recommendations. We assigned a quality score for each study to evaluate the information and selection bias. The certainty of the pooled data for all articles was assessed based on GRADE criteria. The Funnel plot asymmetry study was used to evaluate publication bias.

Results

The overall pre-treatment ICC, Rout, and PVI were 0.45 ml/mmHg (95% CI, 0.33-0.57; I2=99.7%; P<0.001), 14.93 mmHg/(ml/min) (95% CI, 13.65-16.21; I2= 99.7%; P<0.001) and 19.26 ml (95% CI, 15.63-22.89; I2=98.7%; P<0.001), respectively. The pooled Rout was observed to be higher in adult hydrocephalus compared to pediatric hydrocephalus, whereas the opposite trend was found for PVI. Patients with normal pressure hydrocephalus (NPH) exhibited a higher pooled Rout compared to communicating hydrocephalus. Patients with unimproved outcomes demonstrated a decrease in the effect size of the pooled Rout. The results also showed significant correlations were observed between all ICP characteristics and both the ICC and Rout. The correlation between ICC and the ventricular score was significant. Rout had a significant correlation with the third ventricle index. PVI had significant correlations with Evan's ratio, inverse cella media, and ventricular score.

Conclusion

The results indicate the possible reason for publication bias in some subgroups may be related to methodological heterogeneity in the measurement of pressure-volume parameters. This finding motivates researchers to investigate the effects of different invasive and non-invasive methods on the measurement results of ICC, Rout, and PVI.

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脑积水患者颅内顺应性、csf流出阻力和压力-容量指数:一项系统综述和荟萃分析
目的颅内顺应性(ICC)、脑脊液流出阻力(Rout)和压积指数(PVI)的变化如何在阐明脑积水生物机制的复杂性和治疗结果方面发挥重要作用。本研究旨在对脑积水患者的ICC、Rout和PVI与颅内压(ICP)特征以及形态测量参数之间的相关性进行全面综述。材料和方法从PubMed/MEDLINE、Scopus、Google Scholar、Ovid、Cochrane和EMBASE数据库成立之日至2022年12月,使用英语文章过滤器进行电子搜索。文章选择和数据收集是根据PRISMA指南和建议进行的。我们为每项研究分配了一个质量分数,以评估信息和选择偏差。根据GRADE标准评估所有文章的合并数据的确定性。漏斗图不对称性研究用于评估发表偏倚。结果治疗前ICC、Rout和PVI分别为0.45 ml/mmHg(95%CI,0.33-0.57;I2=99.7%;P<;0.001)、14.93 mmHg/(ml/min)(95%CI为13.65-16.21;I2=97.7%;P>;0.001)和19.26 ml(95%CI:15.63-22.89;I2=98.7%;P&<;0.001)。与儿童脑积水相比,成人脑积水的合并Rout更高,而PVI则相反。与交通性脑积水相比,正常压力性脑积水(NPH)患者表现出更高的合并Rout。结果未改善的患者表现出合并Rout的效果大小降低。结果还表明,所有ICP特征与ICC和Rout之间都存在显著相关性。ICC与心室评分之间存在显著相关性。Rout与第三脑室指数有显著相关性。PVI与Evan比率、反细胞培养基和心室评分显著相关。结论某些亚组发表偏倚的可能原因可能与压力-体积参数测量方法的异质性有关。这一发现促使研究人员研究不同的侵入性和非侵入性方法对ICC、Rout和PVI测量结果的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Irbm
Irbm ENGINEERING, BIOMEDICAL-
CiteScore
10.30
自引率
4.20%
发文量
81
审稿时长
57 days
期刊介绍: IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux). As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in: -Physiological and Biological Signal processing (EEG, MEG, ECG…)- Medical Image processing- Biomechanics- Biomaterials- Medical Physics- Biophysics- Physiological and Biological Sensors- Information technologies in healthcare- Disability research- Computational physiology- …
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