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Applicability of near-infrared spectroscopy to measure cerebral autoregulation non-invasively in neonates: a validation study in piglets.
MedLine Citation:
PMID:  21566541     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Impaired cerebral autoregulation (CA) is common and associated with brain damage in sick neonates. Frequency analysis using spontaneous changes in arterial blood pressure (ABP) and cerebral near-infrared spectroscopy (NIRS) has been used to measure CA in several clinical studies. Coherence of the NIRS and ABP signals (i.e. correlation in the frequency-domain) detects impairment of CA, whereas gain (i.e. magnitude of ABP-variability passing from systemic to cerebral circulation) estimates the degree of this impairment. So far, however, this method has not been validated. In twelve newborn piglets, we compared NIRS-derived measures of CA with a conventional measure of CA: cerebral blood flow was measured by laser Doppler flowmetry and changes in ABP were induced by inflating a thoracic aorta balloon. CA-capacity was calculated as %ΔCVR/%ΔABP (i.e. percentage of full autoregulatory capacity), where CVR (i.e. cerebral vascular resistance) was estimated as ABP/Doppler flux. Correlation between coherence and CA-capacity (r=-0.34, n=24, p>0.05) as well as between gain and CA-capacity (r=-0.11, n=24, p>0.05) was limited. As expected, however, gain was significantly associated with CA-capacity in measurements with significant coherence (r=-0.55, n=15, p=0.03). In conclusion, our data validate frequency analysis for estimation of cerebral autoregulation in clinical research. Low precision, however, hampers its clinical application. ABBREVIATIONS::
Authors:
Gitte H Hahn; Christian Heiring; Ole Pryds; Gorm Greisen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-11
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neonatology [G.H.H., G.G.], Copenhagen University Hospital - Rigshospitalet, DK-2100 Copenhagen, Denmark; Department of Pediatrics [C.H.], Hillerød Hospital, DK-3400 Hillerød, Denmark; Department of Pediatrics [O.P.], Copenhagen University Hospital - Hvidovre Hospital, DK-2650 Hvidovre, Denmark.
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