ICM+ software®
The Intensive Care Monitoring (ICM+) software is a software program developed by the Clinical Neuroscience Department in Cambridge (Department of Neurosurgery, Addenbrooke’s Hospital Cambridge, University of Cambridge). Many hospitals in the world use this program for both online and offline datacollection and multimodal monitoring on the intensive care or in specialised neurophysiology laboratories. The continuously updated software is user friendly and contains many applications for complex neuromonitoring and autoregulation calculations. [1]
In the current software there are many options to explore or customize the optimal cerebral perfusion pressure (CPPopt) algorithm. At present this function is mainly applied using the parameters intracranial pressure (ICP) and arterial blood pressure (ABP). However, ‘optimal’ calculations have also with success been suggested in out of hospital cardiac arrest patients and in premature neonates both by using near infrared spectroscopy (NIRS) instead of ICP.
An option to explore CPPopt with ICP and ABP is to display the ‘CPP-PRx error bar’. The CPPopt U-shape curve can be fitted by an automated mathematical algorithm and the CPPopt value automatically displayed. The other option is to display the CPPopt calculation over time as a ‘CPPopt trend line’ with the extra features for weighting and averaging. In the very near future a third option will be expanded with visualizing the CPPopt trend in the context of the cerebrovascular pressure reactivity (‘landscape’ of CPPopt/PRx).[2] Both options are discussed in the CPPopt calculation dropdown menu ‘CPP PRx Error Bar’ and ‘CPPopt Trends’.
3. Data analysis with ICM+ - CPPoptReferences
[2]. Aries MJ, Wesselink R, Elting JW, Donnelly J, Czosnyka M, Ercole A, Maurits NM, Smielewski P. Enhanced Visualization of Optimal Cerebral Perfusion Pressure Over Time to Support Clinical Decision Making. Crit Care Med. 2016 Oct;44(10):e996-9.