• Guillaume Plourde, François Martin Carrier, Philippe Bijlenga, and Hervé Quintard.
• Division of Intensive Care Medicine, Department of Medicine, Centre Hospitalier de l'Université de Montréal, 1051 Rue Sanguinet, Montreal, Canada. guillaume.plourde.1@umontreal.ca.
• Neurocrit Care. 2024 Feb 29.

BackgroundNeuromonitoring devices are often used in traumatic brain injury. The objective of this report is to raise awareness concerning variations in optimal cerebral perfusion pressure (CPPopt) determination using exploratory information provided by two neuromonitoring monitors that are part of research programs (Moberg CNS Monitor and RAUMED NeuroSmart LogO).MethodsWe connected both monitors simultaneously to a parenchymal intracranial pressure catheter and recorded the pressure reactivity index (PRx) and the derived CPPopt estimates for a patient with a severe traumatic brain injury. These estimates were available at the bedside and were updated at each minute.ResultsUsing the Bland and Altman method, we found a mean variation of - 3.8 (95% confidence internal from - 8.5 to 0.9) mm Hg between the CPPopt estimates provided by the two monitors (limits of agreement from - 26.6 to 19.1 mm Hg). The PRx and CPPopt trends provided by the two monitors were similar over time, but CPPopt trends differed when PRx values were around zero. Also, almost half of the CPPopt estimates differed by more than 10 mm Hg.ConclusionsThese wide variations recorded in the same patient are worrisome and reiterate the importance of understanding and standardizing the methodology and algorithms behind commercial neuromonitoring devices prior to incorporating them in clinical use.© 2024. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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