1. How can we create and analyze ‘new signals’ using ICM+?
Magdalena Kasprowicz
How can we create and analyze
‘new signals’ using ICM+?
ICM+ user’s club meeting
12 September 2010, Tubingen

2. What ‘new signals’ can be analysed using ICM+?
Raw data: ABP and CBFV
Cerebral arterial blood volume (CaBV)
Cerebral arterial compliance (Ca)
Cerebrovascular time constant of arterial bed ()
Raw data: ABP, CBFV and ICP
Cerebrospinal + venous compliance (Ci)
Intracranial compliance ceofficient (ICC)

3. Cerebral arterial inflow Cerebral venous outflow
R-R interval
of ECG
mean
CBV + -
CBFa(t)
CBFv(t)
Cerebral arterial blood volume (CaBV)
Cerebral arterial inflow
mean
CBFa
Cerebral venous outflow
CBV(t)
t t2
Cerebral blood volume
Avezaat CJ, van Eijndhoven JH. (1986) The role of the pulsatile pressure variations in intracranial pressure monitoring. Neurosurg Rev 9:

4. Defining new virtual signals step by step

5. Cerebral arterial blood volume (CaBV)
Integrate(fv-MovingAvgFilter(fv,300))
Integrate()
MovingAvgFilter(,)

6. CaBV- Response to changes in EtCO2

7. Compartmental compliances of brain
Cerebral arterial compliance (Ca)
Cerebrospinal + venous compliance (Ci)

8. Cerebral arterial compliance (Ca)
Mean(AMP_CaBV) / Mean(Amp_ABP)
FundAmp(CBV,’BPM&LWR&=40&UPR=120’
FundAmp
FundAmp(ABP,’BPM&LWR&=40&UPR=120’
FundAmp
Since we have already defined CBV as a new virtual signal, now we cam move to promary analysis and calculate compliance

9. Ca - Response to changes in EtCO2

10. Compartmental compliances (Ca, Ci)

11. Intracranial compliance coefficient (ICC)
Correl (Ci, Ca)
Correl

12. Intracranial compliance coefficient (ICC)

13. Cerebrovascular time constant ()
Mean(Ca) * Mean (CVR)
Mean(ABP) / Mean (FV)

14. - Response to changes in EtCO2
[mmHg]
[cm/s]
[kPa]
[s]

15. Conclusions ICM+ data analysis is simple! ICM+ software provides:
a graphical, user-friendly interface
a comprehensive set of functions for data analysis
basic operators (additon, substraction, etc)
more complex time-domain function (mean, median, cross-correlation)
frequency doamain function (power, fundamental frequency, coherence)
a pipe-like data flow analysis
virual signals (input)  primary analysis  secendary analysis  final anlysis
number of ‘new signals’ which can be incorporated in the software ICM+ is unlimited

16. Cerebrovascular time constant in carotid artery occlusive disease
Monday, September 13, 2010
10:20–11:40 ICP and the Cerebrovascular System
Changes in cerebral compartmental compliances during mild hypocapnia in patients with traumatic brain injury
E. Carrera, L. A. Steiner , G. Castellani, P. Smielewski, C. Zweifel, C. Haubrich, J. D. Pickard, D. Menon, M. Czosnyka
Cerebrovascular time constant
in carotid artery occlusive disease
M. Kasprowicz , C. Haubrich, P. Smielewski, J. Diedler, E. Carrera, E. Sorrentino, Z. Czosnyka, J. D. Pickard, M. Czosnyka
Wednesday, September 15, 2010
15:10–15:50 Severe TBI – Insights
Continuous monitoring of Monro-Kellie doctrine in traumatic brain injury
Dong-Joo Kim, M. Czosnyka, E. Carrera, C. Haubrich, Z. Czosnyka, M. Kasprowicz, P. Smielewski, M. Balestreri, A. Pena, O. Baledent, J. D. Pickard

17. Thank you