| Rapid assessment of cerebral autoregulation by near-infrared spectroscopy and a single dose of phenylephrine. | |
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MedLine Citation:
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PMID: 21258266 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Rapid bedside determination of cerebral blood pressure autoregulation (AR) may improve clinical utility. We tested the hypothesis that cerebral hemoglobin oxygenation (HbDiff) and cerebral hemoglobin volume (HbTotal) measured by near-infrared spectroscopy (NIRS) would correlate with cerebral blood flow (CBF) after single dose phenylephrine (PE). Critically ill patients requiring artificial ventilation and arterial lines were eligible. During rapid blood pressure rise induced by i.v. PE-bolus, ΔHbDiff and ΔHbTotal were calculated by subtracting values at baseline ("normotension") from values at peak blood pressure elevation ("hypertension"). With the aid of NIRS and bolus injection of indocyanine green, relative measures of CBF, called blood flow index (BFI), were determined during "normotension" and during "hypertension". BFI during "hypertension" was expressed as percentage from BFI during "normotension" (BFI%). Autoregulation indices (ARI) were calculated by dividing BFI%, ΔHbDiff and ΔHbTotal by the concommittant change in blood pressure. In 24 patients (11 newborns, 13 children) significant correlations between BFI% and ΔHbDiff (or ΔHbTotal) were found. In addition, the associations between hemoglobin based ARI and BFI% based ARI were significant with correlation coefficients of 0.73 (or 0.72). Rapid determination of dynamic AR with the aid of cerebral hemoglobin signals and PE-bolus appears to be reliable. ABBREVIATIONS: |
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Authors:
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Bendicht P Wagner; Roland A Ammann; Denis C G Bachmann; Susanne Born; Andreas Schibler |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-1-20 |
Journal Detail:
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Title: Pediatric research Volume: - ISSN: 1530-0447 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-1-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Pediatrics [B.P.W., R.A.A., D.C.G.B., S.B.], University of Berne, Inselspital, 3010 Berne, Switzerland; Department of Pediatrics [A.S.], Mater Children's Hospital Mater, Mater Misericordiae Hospitals, South Brisbane QLD 4101, Australia. |
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