<p>Appendix F: Neurophysiologic Measure Studies - CMD Measures and Physiologic Associations</p><p>Reference Catheter Interventio Physiologic CMD Analytes and Complications to Conclusions Location nal Parameter Physiologic Outcome CMD and Therapies Measured Measured Applied CMD During Analytes Measureme of nt Interest ICP/CPP Positive Association Studies Adamides Mixed Standard ICP/CPP Labile ICP was associated with labile LPR, Not Specified Absolute Lactate et al [1] Peri- ICP/CPP Lactate, and Glutamate levels. Episodes of elevation, peak Lesion Directed elevated ICP/low CPP were associated with lactate, baseline and Therapy elevations in Lactate, LPR, and Glutamate lactate, and baseline Healthy which occurred 2 to 3 hours prior. LPR/glycerol were Tissue associated with Absolute Lactate elevation, peak lactate, elevated ICP/low CPP Glucose, baseline lactate, and baseline LPR/glycerol Lactate, were associated with elevated ICP/low CPP Pyruvate, (p<0.05) Glutamat e, Glycerol</p><p>(Hourly Measure)</p><p>Belli et al Peri- Standard ICP Elevated LPR, glutamate, and glycerol were No Complications Elevated LPR, [7] Lesional ICP/CPP correlated to increased ICP (p<0.001) glutamate, and Tissue Directed glycerol were Therapy; LPR >25 and Glycerol >100 umol/L were correlated to Lactate, Varied end- associated with abnormal ICP (p<0.001) increased ICP Pyruvate, tier ICP LPR, therapies Glutamat (DC, etc.) e</p><p>(q12 Hour Measure)</p><p>Bolcha et al Unclear Not ICP and PbtO2 ICP: High ICP was associated with high LPR and Not Specified High LPR and Glycerol [10] Location Specified Glycerol are associated with high ICP. High LPR is</p><p>Glucose, PbtO2: High LPR correlated with low PbtO2 associated with low</p><p>Glycerol, PbtO2. LPR</p><p>(Unclear Interval)</p><p>Bullock et Mixed Standard ICP/CPP High Glutamate (>20 umol/L) was associated 3 catheters High Glutamate is al [12] Peri- ICP with elevated ICP/low CPP (p=0.0104) malfunctioned associated with Lesion Therapy; requiring elevated ICP and “Few” with Glutamate was linearly correlated to the replacement Healthy barbiturate severity of secondary ischemic episodes</p><p>Tissue infusions (defined by ischemia score; PaO2, MABP, Xe CT, pupil response, CPP) (p=0.025) Glutamat e</p><p>(q30 min Measure for 4 days)</p><p>Clausen et Healthy Various ICP CPP and PbtO2 PbtO2: Glycerol levels negatively correlated Not Specified High Glycerol levels</p><p> al [17] Tissue Therapies with PbtO2 (p<0.001) are associated with low PbtO2 and low Glycerol CPP: Glycerol levels negatively correlated with CPP. CPP (p<0.05) (q30 min Measure)</p><p>Clausen et Healthy Various ICP CPP and PbtO2 CPP: High lactate observed in episodes of low Not Specified High Lactate is with</p><p> al [18] Tissue Therapies; CPP (mean 1027 umol/L), with the largest low CPP and PbtO2. Barbiturate mean change in lactate correlating significantly Lactate s; (p<0.05) Hypothermi</p><p>(q30 min a PbtO2: High lactate was associated with low</p><p>Measure) PbtO2. (p<0.05)</p><p>Goodman Healthy Various ICP ICP As Glutamate decreases (with progressive Not Specified Glutamate Levels are et al [26] Tissue Therapies sedation) so does ICP Associated with ICP (including Glutamat Barbiturate e s)</p><p>(q 30min Measure)</p><p>Goodman Mixed Various ICP ICP, SjVO2, PbtO2 ICP: Lactate increases and Glucose decreases Not Specified Increases in Lactate et al [25] Peri- Therapies; as ICP continuously increases and Glucose were Lesion DC associated with an</p><p> and SjvO2: Elevated Lactate (median increase increase in ICP and</p><p>Healthy >0.322 umol/L) was associated to decrease in decrease in SjvO2</p><p>Tissue SjvO2 (p=0.002). The change in Glucose was</p><p> related to the severity of SjVO2 decrease Lactate (p=0.032) and</p><p>Glucose PbtO2: Increased in Lactate did not correlate to</p><p> local changes in PbtO2. (Unclear Interval)</p><p>Gupta et al Unclear ICP/CPP ICP LPR and CPP displayed a negative correlation Not Specified Elevations in LPR are [28] Location Directed (p=0.029) associated with a Therapy decrease in CPP Glycerol, Lactate, Pyruvate, LPR</p><p>(Unclear Interval)</p><p>Hejcl et al Unclear Not ICP/CPP, PbtO2 ICP/CPP: High LPR associated with elevated ICP Not Specified High LPR is associated [34] Location Specified (p<0.05), and low CPP (p<0.05) with high ICP and low CPP/PbtO2. High Glucose, High Glycerol associated with elevated ICP Glycerol is associated Glycerol, (p<0.05) with high ICP LPR</p><p>PbtO2: High LPR was associated with low PbtO2 (Unclear (p<0.05) Interval)</p><p>Koura et al Unclear Not ICP Elevated Glutamate was associated with Not Specified High Glutamate is [47] Location Specified elevated ICP associated with ICP elevations Glutamat e</p><p>(Unclear Interval for 5 days) Kurtz et al Unclear ICP CPP and PbtO2 CPP: Low Glucose is associated with low CPP Not Specified Low glucose is [48] Location Therapies; associated with low</p><p>Hypothermi PbtO2: High LPR and Low Glucose is associated CPP/PbtO2. High LPR</p><p>Glucose, a with low PbtO2 is associated with low</p><p>Lactate, PbtO2 LPR</p><p>(Hourly Measure)</p><p>Li et al [51] Mixed Various ICP ICP/CPP and CBF ICP/CPP: High Glycerol was associated with Not Specified High Glycerol is Peri- Therapies (Laser Doppler decreased CPP and increased ICP associated with high Lesion Flowmetry) ICP and low CPP/CBF and CBF: High Glycerol was associated with Healthy reduced CBF Tissue</p><p>Glycerol</p><p>(Hourly Measure)</p><p>Meixensber Peri- Variable ICP and PbtO2 ICP: Glutamate was only associated with CMD catheter High Glutamate is ger et al Lesional Surgical and severe spikes in ICP in some cases failure in 5 sometimes associated [56] Medical with ICP spikes.</p><p>Glucose, Treatments PbtO2: Elevated LPR (>25) was associated with Elevated LPR is</p><p>Lactate, for ICP low PbtO2 (p<0.001) associated with low</p><p>Pyruvate, PbtO2. LPR, Glutamat e</p><p>(q1-2 Hour Measures)</p><p>Nelson et al Mixed ICP and CPP ICP/CPP Strong correlation between ICP/CPP and all Not Specified Low glucose, high [61] Peri-lesion directed CMD measures (ie. Low glucose, high lactate/LPR/glycerol and Therapy; lactate/LPR/glycerol seen in episodes of high seen in episodes of Healthy some with ICP/low CPP) high ICP/low CPP DC, Glucose, barbiturate Lactate, s, Pyruvate, hypothermi Glycerol a</p><p>(Hourly Measures)</p><p>Nordstrom Mixed Lund CPP Low CPP (<20 mmHg) corresponded to increase Not Specified LPR increases when et al [62] Peri- Therapy in LPR CPP drops Lesion dramatically and Healthy Tissue</p><p>Glucose, Lactate, Glutamat e, Glycerol</p><p>(Hourly Measure)</p><p>Papanikola Unclear Not ICP Elevated Glycerol predicted ICP increase Not Specified Lactate, Pyruvate, LPR ou et al Location Specified and Glycerol do not [68] correlate with Lactate, outcome Pyruvate, LPR, Glycerol</p><p>(Unclear Interval)</p><p>Paraforou Peri- ICP ICP High LPR and Glycerol occurred during times of Not Specified High LPR and Glycerol et al [69] Lesional Directed sustained ICP elevations may be seen in Therapy circumstances of Glucose, elevated ICP Glycerol, Pyruvate, Lactate</p><p>(q2 hour Measure)</p><p>Richards et Healthy ICP ICP Mean glutamate levels positively correlated to Not Specified Glutamate at 12h and al [75] Tissue Therapies ICP (p<0.05) 24h post injury correlate to outcome Glutamat No significant correlation between hourly at 3 months e glutamate and ICP/CPP/MABP/CVP</p><p>(Hourly Measure)</p><p>Salci et al Unclear Non- ICP and Compliance High LPR correlates with High ICP and Poor Not Specified High LPR is associated [79] Location specific Compliance (p<0.0001) to increased ICP and therapies poor compliance Lactate, directed at Pyruvate, ICP/CPP LPR (Unclear Interval)</p><p>Sarrafzade Healthy Not ICP, SjvO2 and ICP: High ICP (>20 mm Hg) was associated with Not Specified High Glutamate is h et al [82] Tissue Specified PbtO2 a 4-5 fold increase in Glutamate associated with high ICP and low</p><p>Glucose, SjvO2: Low SjvO2 was associated with elevated SjvO2/PbtO2. High Lactate, Glutamate, Lactate, and Glycerol Lactate and Glycerol is Glycerol, associated with low</p><p>Glutamat PbtO2: Low PbtO2 was associated with elevated SjvO2/PbtO2 e Glutamate, Lactate, and Glycerol</p><p>(Hourly Measure)</p><p>Singla et al Unclear Not ICP LPR and Glycerol levels increase as CPP Not Specified LPR and Glycerol [86] Location Specified decreased levels increase as ICP increases LPR</p><p>(Unclear Interval)</p><p>Stahl et al Mixed Varied ICP As ICP progressively increases towards Not Specified As ICP increases to [87] Uni- and Failed ICP herniation, Glycerol/Glutamate/LPR increase herniation, Bilateral Therapies and Glucose decreases Glycerol/Glutamate/L in Peri- PR increase, while Lesion Glucose decreases and Healthy Tissue</p><p>Lactate, Pyruvate, Glutamat e, Glycerol</p><p>(q30-60 min Measure)</p><p>Stein et al Unclear Unclear ICU ICP Metabolic crisis (LPR>40) was associated with Not Specified Elevated LPR may be [89] Location protocols elevated ICP associated with sustained ICP Glucose, elevations Lactate, Pyruvate</p><p>(Unclear Interval for 7 days)</p><p>Stiefel et al Unclear Not CPP Impaired Metabolism (LPR>25) was found in Not Specified Elevated LPR (>25) [91] Location Specified associated with abnormal MMM (varied may be found in techniques; CPP, NIRS, PbtO2) episodes of abnormal Lactate, MMM Pyruvate, LPR</p><p>(Hourly Measure for 3 days)</p><p>Timofeev Mixed Not ICP and PRx ICP: Glutamate, Glycerol and LPR were found Not Specified Elevated Glutamate, et al [93] Peri-lesion Specified to elevated in those with high mean ICP values Glycerol and LPR may and be seen in those with Healthy PRx: Glutamate, Glycerol and LPR were found high ICP and Tissue to be elevated in those with positive PRx values abnormal PRx</p><p>Glucose, Lactate, Pyruvate, Glutamat e, Glycerol, LPR</p><p>(Hourly Measure)</p><p>Timofeev Unclear Not ICP/CPP, PRx, PbtO2 ICP/CPP: Increased LPR was seen with an Not Specified Increased LPR may be et al [94] Location Specified increase in ICP and decrease in CPP seen in settings of High ICP, low</p><p>Lactate, PRx: Increased LPR was associated with CPP/PbtO2, and Pyruvate, abnormal PRx abnormal PRx LPR</p><p>PbtO2: Increased LPR was seen in the setting of</p><p>(Unclear low PbtO2 Interval)</p><p>Vespa et al Unclear Standard ICP/CPP Glutamate elevations (>20 uM) were seen in No complications Glutamate elevations [98] Location ICP/CPP episodes of decreased CPP (p<0.001) and (>20 uM) may be seen Directed increased ICP at various time points during in episodes of Glutamat Therapy; admission decreased CPP and e Barbiturate elevated ICP s (Hourly intermittent Measure; ly 9 days) PbtO2/SjvO2 Positive Association Studies</p><p>Chan et al Unclear Not SjvO2 Rapid increase in Glutamate, Glycerol and Not Specified Increase in [15] Location Specified Lactate were ween with SjvO2 levels below 40 Glutamate/Glycerol/L to 45% actate and Decrease Glucose, in Glucose can be</p><p>Lactate, Glucose decreased with SjvO2 below 42% seen with a decrease</p><p>Glutamat in SjvO2 to 40 to 45% e, Glycerol</p><p>(Unclear Interval)</p><p>Figaji et al Unclear Not PbtO2 LPR increased with low PbtO2 Not Specified High LPR is associated [21] Location Specified with low PbO2</p><p>Lactate, LPR, glycerol</p><p>(Unclear Interval)</p><p>Menzel et Unclear Varied PbtO2 Lactate decreased during increase in PaO2 and Not Specified Lactate decreases</p><p> al [57] Location therapies PbtO2 with increased PbtO2 directed Glucose, toward ICP Glucose displayed no relationship Lactate Group 1</p><p>(q30 min (n=12): FiO2 Measure) directed to</p><p>PaO2 of 100 to 150 mm Hg</p><p>Group 2 (n=12): Sequential increase in</p><p>FiO2 to 60% and then 100%</p><p>Menzel et Unclear Unclear PbtO2 During baseline measures there was no Not Specified Lactate may decrease</p><p> al [58] Location therapies; correlation between lactate and glucose with with increasing PbtO2</p><p>PbtO2 Glucose, N=14 with Lactate hyperoxia During hyperoxia Lactate decreased with a</p><p> therapy – corresponding increase in PbtO2. (q30 min sequential</p><p>Measure) increase in Glucose showed no clear trend with PbtO2</p><p>FiO2 up to druring hyperoxia. 100%</p><p>15 Nortje et al Unclear Standardize PbtO2 and O PET PbtO2: LPR decreased as PbtO2 increased during Not Specified LPR may decrease</p><p>[63] Location d Protocol hyperoxia. Not significant changes were note with increasing PbtO2 for lactate, pyruvate, glucose, glutamate and Glucose, Hyperoxia glycerol in isolation. Lactate, Therapy: Pyruvate, Unclear PET: 15O PET update focally was seen with Glutamat hyperoxia, but this did not correlate to LPR e, changes. Glycerol</p><p>(q20 min Measure) Purins et al Unclear ICP/CPP PbtO2 Glutamate increases significantly with PbtO2 Not Specified LPR, Glutamate and [72] Location directed below 5 mm Hg (p<0.05) Glycerol increase as</p><p> therapies; PbtO2 drops below 5</p><p>Glucose, variable Glycerol increases significantly with PbtO2 mm Hg. Glucose Lactate, treatments below 5 mm Hg (p<0.05) doesn’t respond to</p><p>Pyruvate, decrease PbtO2 levels.</p><p>Glutamat LPR increase with PbtO2 below 5 mm Hg e, (p<0.01) Glycerol No significant correlation between glucose and</p><p>(Hourly PbtO2 Measure)</p><p>Robertson Unclear Not PbtO2 and CBF High Glutamate/Aspartate levels were Not Specified High Glutamate levels et al [76] Location Specified (TCD) negatively correlated to diffuse brain injury, are associated with</p><p>PbtO2, and CBF (TCD) mortality Glutamat e</p><p>(q30 min Measure)</p><p>Sarrafzade Unclear Not PbtO2 As PbtO2 dropped to 10-15 mm Hg (for 5 min), Not Specified Increases in h et al [83] Location Specified glutamate increased (p=0.006) Glutamate, Lactate and LPR can be seen</p><p>Glucose, As PbtO2 drops below 10 mm Hg (5 min), with decreasing PbtO2 Lactate, Glutamate (p<0.001), Lactate (p=0.001), and Pyruvate, LPR (p=0.088) increased LPR, Glutamat e</p><p>(Hourly Measure) Sarrafzade Unclear Not PbtO2 Glucose dropped significantly prior to PbtO2 Not Specified Decreased glucose h et al [84] Location Specified decreasing to 10 mm Hg. may predict PbtO2 defined hypoxia.</p><p>Glucose, Glutamate displayed no relationship to PbtO2 Glutamate does not Lactate, seem to correlate. LPR, Glutamat e</p><p>(Hourly Measure)</p><p>Timofeev Mixed Standardize PbtO2 Strong negative correlation between LPR Not Specified LPR may correlate to</p><p> et al [85] Peri- d protocol; (p<0.001) and lactate (p<0.001) and PbtO2 PbtO2 Lesion individual and patients not Healthy all same Tissue</p><p>Glucose, Lactate, Pyruvate, LPR, Glycerol, Glutamat e</p><p>(Hourly Measure) Valdaka et Unclear Non- PbtO2 Lactate, Glutamate, LPR and potassium Not Specified Limited. Significant</p><p> al. [96] Location specific increase significantly as PbtO2 approaches zero. derrangements seen treatment during death. Glucose, Lactate, Glutamat e</p><p>(q30 min Measure)</p><p>Vilalta et al Healthy ICP/CPP PbtO2 During hyperoxia increases in PbtO2 (mean Not Specified Increased glucose [101] Tissue therapy; no increased from 26.9 mm Hg to 97.7 mm Hg) with decreases in very clear occur in concert with increases in glucose LPR/Lactate/Pyruvate Glucose, (p=0.037) and decreases in LPR (p=0.005), may be seen with</p><p>Lactate, Hyperoxia lactate (p<0.001) and pyruvate (p=0.002) increases in PbtO2 Pryuvate, Therapy: Glutamat obtain e baseline, then (Hourly increase</p><p>Measure) FiO2 to 100%</p><p>Autoregulation - Positive Association Studies</p><p>Asgari et al Unclear Unclear MOCAIP ICP Occasional LPR increases seen in circumstances Not Specified LPR may be increased [4] Location Therapy Waveform based of autoregulation dysfunction in situation with Autoregulation abnormal Lactate, Measurements autoregulation Pyruvate, LPR</p><p>(Unclear Interval) Asgari et al Unclear Not PMTM ICP Some association between LPR increase and Not Specified Increased LPR may [5] Location Specified Waveform Analysis vasoconstriction correlated to for vasoconstriction in Lactate, Vascoconstriction/V some cases Pyruvate, asodilatation LPR</p><p>(Unclear Interval)</p><p>Yokobori et Peri- Standard PRx There was a positive correlation between Not Specified LPR and Glucose al [105] Lesional ICP/CPP improvement in PRx and CMD glucose levels changes may directed correlate to PRx based Glucose, therapy There was a negative correlation between changes Glutamat improved PRx and LPR e, Glycerol, Lactate, Pyruvate, LPR</p><p>(Hourly Measure)</p><p>Imaging Based Positive Association Studies</p><p>Bouzat et al Healthy ICP/CPP CTP assessment of Low Glucose and elevated LPR were associated Not Specified Low Glucose and [11] Tissue Directed CBF during with a reduction in rCBF (p<0.05) elevate LPR correlated Therapy; no episodes of brain to a reduction in rCBF</p><p>Lactate, specifics hypoxemia (PbtO2 as per CTP Pyruvate, <20 mm Hg for 5 LPR, min) or “Abnormal” Glucose CMD measures (Glucose <1 mmol/L (Unclear and LPR >40) Interval) 15 Hutchinson Unclear Standard H2 O PET (with ROI Positive correlation between OEF and LPR Not Specified LPR and OEF seem to et al [39] Location Protocols; around probe (p=0.002) be positively no specifics location) correlated Glucose, Lactate, Pyruvate, Glutamat e</p><p>(q20 min Measure) Hutchinson Unclear Standard FDG PET (ROI Lactate and Pyruvate displayed a positive linear Not Specified Lactate, Pyruvate and et al [40] Location Protocol; no around probe correlation to CMRglc (p<0.0001) Glutamate displayed a further location) positive correlation to Glucose, details Weak positive correlation between CMRglc and CMRglc Lactate, Glutamate Pyruvate, Glutamat No relationship between CMRglc and LPR or e Glucose was seen</p><p>(q30 min Measure)</p><p>Reinert et Mixed Not Xe CT and ICP Negative correlation between potassium and Not Specified Potassium has a al [74] Peri- Specified CBF (p=0.019) negative correlation Lesion to Xe CT CBF and Positive correlation between mean potassium Healthy and ICP >30 mm Hg (p<0.0001) Tissue</p><p>Potassiu m, Lactate, Glutamat e</p><p>(q30 min Measure)</p><p>Sala et al Unclear Standard CTP at 24 and 48 CTP: Glycolytic Lactate elevations (normal Not Specified Hypoxic Lactate</p><p>[78] Location ICP/CPP hours post injury PbtO2) were associated with elevations are Protocol normal/supranormal perfusion. Hypoxic associated with global</p><p>Glucose, ICP lactate elevations (PbtO2 < 20 mm Hg for 5 min) oligemia Lactate, were associated with global oligemia. Pyruvate, Glutamat ICP: Glycolytic lactate elevations were not e associated with ICP elevations</p><p>(Hourly Measure)</p><p>15 Vespa et al Unclear Standard FDG PET and C O, LPR was negatively correlated to CMRO2 Not Specified LPR displays a 15 15 [97] Location ICP/CPP O O, H2 O PET (p<0.001) negative correlation</p><p>Directed (ROI around probe to CMRO2 Glucose, Therapy location) No other correlations detected Lactate, Pyruvate, Glutamat e, Glycerol</p><p>(Hourly Measure)</p><p>Vespa et al Healthy None FDG PET (ROI Mean daily CMD glucose = 0.05 to 3.2 mmol/L No Complications Glucose is positively [99] Tissue Mentioned around probe correlated to FDG PET location) and Xe CT CMD glucose value of 0.2 mmol/L (or lower) signal and Xe CT CBF Glucose, corresponded to an increase in FDG signal on Lactate PET</p><p>(Hourly CMD glucose positively correlated with Xe CT Measure) CBF measurements (p<0.001)</p><p>Zauner et Unclear Not Xe CT Elevations in glutamate corresponded Not Specified Elevations in al [109] Location Specified positively to reductions in CBF glutamate may correspond to Glutamat reductions in CBF as e assessed by Xe CT</p><p>(Unclear Interval)</p><p>Negative Association Studies Alessandri Unclear Not ICP No correlation between Sodium/Glutamate Not Specified Sodium and et al [3] Location Specified with ICP was identified Glutamate levels do not correlate with ICP Sodium, Glutamat e</p><p>(Unclear Interval) Chamoun Unclear Various ICP ICP/PbtO2/SjvO2 No correlation between glutamate and Not Specified Glutamate does not</p><p> et al [13] Location Therapies; MABP/ICP/PbtO2/SjvO2 correlate to</p><p>Some DC MABP/ICP/PbtO2/SjvO</p><p>Glutamat patients 2 e</p><p>(Hourly Measure)</p><p>Johnston et Healthy CPP CPP and PbtO2 No association between CMD measures and Not Specified CMD does not al [44] Brain Directed CPP correlate with CPP or</p><p>Therapy PbtO2 changes Glucose, with Unclear association between CMD measures</p><p>Lactate, augment to and PbtO2 Pyruvate, >70 mm Hg LPR, Glycerol</p><p>(Measure q30 min; unclear how correlated to outcome)</p><p>Nelson et al Bilateral Standard ICP/CPP No common patterns of CMD measures were Not Specified CMD measure do not [60] Location ICP/CPP seen in relation to ICP/CPP correlated to ICP/CPP (one in Therapy changes penumbra ; one in healthy)</p><p>Glucose, Lactate, Pyruvate, LPR, Glutamat e</p><p>(Hourly Collection )</p><p>Peerdeman Healthy ICP/CPP ICP/CPP No association between low CPP and increased Not Specified Glycerol elevations et al [70] Tissue Directed glycerol are not associated Therapy; with ICP/CPP changes Glucose, some No association between elevated ICP and Lactate, barbiturate glycerol Pyruvate, s and Glycerol hypothermi No association between elevated temperature a and glycerol (Unclear Interval)</p><p>Petzold et Mixed Not ICP Unclear relationship between Lactate, Pyruvate Not Specified Questionable al [71] Peri- Specified and LPR to ICP relationship between Lesion Lactate, Pyruvate and and LPR to ICP Healthy Tissue</p><p>Lactate, Pyruvate, LPR</p><p>(Hourly Measure) Sanchez- Unclear Local Long PRx (using 20 No correlation was seen between CMD Not Specified Glucose, Lactate, Porras et al Location Protocol; min averages of measures and Long PRx Pyruvate, Glutamate [81] Individual MAP and ICP data) do not correlate with Glucose, differences Long PRx defined Lactate, autoregulation Pyruvate, Glutamat e</p><p>(Hourly Measure)</p><p>Vespa et al Mixed Not CPP LPR changes occur independent of CPP Not Specified LPR changes occur [100] Peri- Specified changes. independent of CPP Lesion changes. and Healthy Tissue</p><p>Lactate, Pyruvate, LPR</p><p>(Hourly Measure; mean duration 120 hours) TBI = traumatic brain injury, GOS = Glasgow outcome scale, GOSE = Glasgow outcome scale extended, CMD = cerebral microdialysis, RCT = randomized control trial, ICP = intracranial pressure, CPP = cerebral perfusion pressure, NAA = N-acetyl acetate, CSF = cerebrospinal fluid, LPR = lactate:pyruvate ratio, CBF = cerebral blood flow, rCBF = regional cerebral blood flow, SjvO2 = jugular venous oxygen saturation, MABP = mean arterial blood pressure, PbtO2 = partial pressure of oxygen in brain tissue, Mx = autoregulation, PRx = pressure reactivity monitoring, TCD = transcranial Doppler, PET = positron emission tomography, FDG = fluorodeoxyglucose, OEF = oxygen extraction fraction, ROI = region of interest, CMRglc = cerebral metabolic rate of glucose consumption, CMRO2 = cerebral metabolic rate of oxygen consumption, Xe CT = xenon enhanced computed tomography, CTP = compute tomographic perfusion imaging, NIRS = near infrared spectroscopy, MMM = multi-modal monitoring, DC = decompressive craniectomy, mmol = milli-molar, mm Hg = millimeters of mercury, L = liter, umol = micromolar.</p>