Document Detail


Continuous assessment of cerebral autoregulation with near-infrared spectroscopy in adults after subarachnoid hemorrhage.
MedLine Citation:
PMID:  20651272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: In patients with subarachnoid hemorrhage, the assessment of cerebral autoregulation aids in prognosis as well as detection of vasospasm. Mx is a validated index of cerebral autoregulation based on measures of cerebral perfusion pressure and mean flow velocity on transcranial Doppler but is impractical for longer-term monitoring. Near-infrared spectroscopy is noninvasive and suitable for continuous monitoring of cerebral tissue oxygenation using the Tissue Oxygenation Index. In this study, we compared near-infrared spectroscopy-based indices of cerebral autoregulation (TOx) with Mx in patients with subarachnoid hemorrhage.
METHODS: Arterial blood pressure, intracranial pressure, mean flow velocity, and Tissue Oxygenation Index were recorded. Mx and TOx were calculated as moving correlation coefficients between 10-second averaged values of cerebral perfusion pressure and mean flow velocity and between cerebral perfusion pressure and Tissue Oxygenation Index. We also calculated TOxA, the moving correlation coefficient between arterial blood pressure and Tissue Oxygenation Index.
RESULTS: Fifty-one recording sessions were performed in 27 patients with subarachnoid hemorrhage with a total duration of 62.5 hours. Correlations of Mx and TOx over time varied markedly among individual recordings. However, time-averaging over the entire recording interval in each of the 51 recordings, we found correlations between Mx and TOx and between Mx and TOxA were highly significant. This correlation was even stronger after correction for multiple sampling for each patient, reaching r=0.81 for Mx and TOx and r=0.72 for Mx and TOxA.
CONCLUSIONS: Near-infrared spectroscopy can be used to continuously assess cerebral autoregulation in adults after subarachnoid hemorrhage.
Authors:
Christian Zweifel; Gianluca Castellani; Marek Czosnyka; Emmanuel Carrera; Kenneth M Brady; Peter J Kirkpatrick; John D Pickard; Peter Smielewski
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-22
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-22     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1963-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity / physiology
Cerebrovascular Circulation / physiology*
Female
Homeostasis / physiology*
Humans
Male
Middle Aged
Patient Selection
Prognosis
ROC Curve
Severity of Illness Index
Signal Processing, Computer-Assisted
Spectroscopy, Near-Infrared*
Subarachnoid Hemorrhage / diagnosis*,  physiopathology*
Grant Support
ID/Acronym/Agency:
G0001237//Medical Research Council; G9439390//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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