Document Detail

Continuous measurement of autoregulation by spontaneous fluctuations in cerebral perfusion pressure: comparison of 3 methods.
MedLine Citation:
PMID:  18669896     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Clinical application of continuous autoregulation monitoring would benefit from a comparison of curves generated by online monitoring with standard autoregulation curves in animal models. We characterized the accuracy of 3 continuous monitors of autoregulation in a piglet model of hypotension.
METHODS: Piglets 5 to10 days old with intracranial pressure (ICP) at naïve or elevated (20 mm Hg) levels had gradual arterial hypotension induced by a balloon catheter in the inferior vena cava. Elevated ICP was maintained by a continuous infusion of artificial cerebrospinal fluid. Three indices of autoregulation were simultaneously and continuously calculated. A moving, linear Pearson's coefficient between spontaneous slow waves of cerebral perfusion pressure and slow waves of laser-Doppler flux or cortical oxygenation rendered the laser-Doppler index and cerebral-oximetry index, respectively. Similar correlation between slow waves of arterial blood pressure and ICP rendered the pressure-reactivity index. The lower limit of autoregulation was determined directly for each animal by plotting laser-Doppler cortical red blood cell flux as a function of cerebral perfusion pressure. Receiver-operator characteristics were determined for the 3 indices.
RESULTS: The areas under the receiver-operator characteristics curves for discriminating the individual lower limit of autoregulation at low and high ICP were 0.89 and 0.85 for the laser-Doppler index, 0.89 and 0.84 for the cerebral-oximetry index, and 0.79 and 0.79 for the pressure-reactivity index. The pressure-reactivity index performed equally well at low and high ICPs.
CONCLUSIONS: Continuous monitoring of autoregulation by spontaneous slow waves of cerebral perfusion pressure can accurately detect loss of autoregulation due to hypotension in piglets by all 3 modalities.
Ken M Brady; Jennifer K Lee; Kathleen K Kibler; R Blaine Easley; Raymond C Koehler; Donald H Shaffner
Related Documents :
2325356 - Neurological outcome after a severe herpes simplex encephalitis treated with acyclovir ...
12881606 - Prediction of malignant course in mca infarction by pet and microdialysis.
3595046 - Neonatal posterior fossa subdural hematoma.
696306 - Increased intracranial pressure in cystic fibrosis.
10764946 - The cardiovascular effects of pfrfamide and pfr(tic)amide, a possible agonist and antag...
25243656 - High pressure homogenization and two-phased anaerobic digestion for enhanced biogas con...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2008-07-31
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-26     Completed Date:  2008-09-25     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2531-7     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Animals, Newborn
Blood Pressure / physiology*
Brain / blood supply,  physiology
Cerebral Arteries / physiology
Cerebrovascular Circulation / physiology*
Disease Models, Animal
Homeostasis / physiology*
Intracranial Hypertension / physiopathology
Intracranial Hypotension / diagnosis,  physiopathology*
Laser-Doppler Flowmetry / methods*
Oximetry / methods*
Oxygen Consumption / physiology
Physiology / methods
Sus scrofa
Grant Support
P01 NS020020/NS/NINDS NIH HHS; P01 NS020020-240002/NS/NINDS NIH HHS

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

Previous Document:  Synergistic effect of an endothelin type A receptor antagonist, S-0139, with rtPA on the neuroprotec...
Next Document:  Use of ordinal outcomes in vascular prevention trials: comparison with binary outcomes in published ...