CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2018; 05(02): 121-122
DOI: 10.1055/s-0038-1654748
Correspondence
Indian Society of Neuroanaesthesiology and Critical Care

Langfitt Curve: Importance in the Management of Patients with Neurotrauma

Samer S. Hoz
1   Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq
,
Gabriel D. Pinilla-Monsalve
2   Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, United States
,
Huber S. Padilla-Zambrano
3   Department of Neurosurgery, Red Latino, Latin American Organization of Trauma and Neurointensive Care, Neiva, Colombia
,
Andrés M. Rubiano
4   School of Medicine, El Bosque University, Bogotá D.C., Colombia
,
Luis Rafael Moscote-Salazar
3   Department of Neurosurgery, Red Latino, Latin American Organization of Trauma and Neurointensive Care, Neiva, Colombia
4   School of Medicine, El Bosque University, Bogotá D.C., Colombia
5   Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena de Indias, Colombia
› Author Affiliations
Further Information

Publication History

Received: 06 April 2018

Accepted: 16 April 2018

Publication Date:
26 July 2018 (online)

Traumatic brain injury is one of the leading causes of mortality and morbidity among children and young adults in western developed countries. Subsequently to the direct effects, secondary injury is characterized by the activation of different pathophysiologic pathways; intracranial compensatory mechanisms initiate immediately as the secondary injury progresses. Furthermore, intracranial hypertension leads to the development of physiologic events that are crucial for patients’ clinical outcomes.

The intracranial hypertension phenomenon is of clinical significance in patients with brain injury. Brain elastance is defined based on the intracranial pressure (ICP) per volume unit, added to the cranial compartment, whereas compliance is the inverse of the elastance, defined by the change of pressure over the change of volume. Additionally, the elastance curve can be graphically expressed as the lateral changes in the ICP compared with the volume changes within the cranial compartment.

The initial phase (also known as compensatory) is characterized by low elastance and high compliance. Posteriorly, a phase of high elastance and low compliance occurs when the compensatory reserves are depleted.