Plateau Waves of Intracranial Pressure and Autonomic Stress Analysis

The onset of intracranial hypertension in patients with Traumatic Brain Injury (TBI) is a serious complication that can lead to brain death. The increased intracranial pressure (ICP) during the Plateau Waves (PW) triggers decreased cerebral perfusion pressure (CPP), brain blood flow and tissue oxygenation. This phenomenon is associated with intense systemic stress response evidenced by Heart Rate Variability (HRV) as a surrogate of autonomic nervous system dysfunction. HRV data show long memory and dynamical complexity herein evaluated by autoregressive fractionally integrated (ARFI) models and multiscale entropy (ARFI-MSE). The incorporation of short-term dynamics and long-range correlations (LRC) allows an enhanced description of HRV during the PW. © 2020 IEEE.