Dynamic cerebral autoregulation estimates derived from near infrared spectroscopy and transcranial Doppler are similar after correction for transit time and blood flow and blood volume oscillations

Jan Willem J Elting , Jeanette Tas , M.J.H. Aries , Marek Czosnyka , Natasha M Maurits

Abstract

We analysed mean arterial blood pressure, cerebral blood flow velocity, oxygenated haemoglobin and deoxygenated haemoglobin signals to estimate dynamic cerebral autoregulation. We compared macrovascular (mean arterial blood pressure-cerebral blood flow velocity) and microvascular (oxygenated haemoglobin-deoxygenated haemoglobin) dynamic cerebral autoregulation estimates during three different conditions: rest, mild hypocapnia and hypercapnia. Microvascular dynamic cerebral autoregulation estimates were created by introducing the constant time lag plus constant phase shift model, which enables correction for transit time, blood flow and blood volume oscillations (TT-BF/BV correction). After TT-BF/BV correction, a significant agreement between mean arterial blood pressure-cerebral blood flow velocity and oxygenated haemoglobin-deoxygenated haemoglobin phase differences in the low frequency band was found during rest (left: intraclass correlation=0.6, median phase difference 29.5° vs. 30.7°, right: intraclass correlation=0.56, median phase difference 32.6° vs. 39.8°) and mild hypocapnia (left: intraclass correlation=0.73, median phase difference 48.6° vs. 43.3°, right: intraclass correlation=0.70, median phase difference 52.1° vs. 61.8°). During hypercapnia, the mean transit time decreased and blood volume oscillations became much more prominent, except for very low frequencies. The transit time related to blood flow oscillations was remarkably stable during all conditions. We conclude that non-invasive microvascular dynamic cerebral autoregulation estimates are similar to macrovascular dynamic cerebral autoregulation estimates, after TT-BF/BV correction is applied. These findings may increase the feasibility of non-invasive continuous autoregulation monitoring and guided therapy in clinical situations.
Author Jan Willem J Elting - [University of Groningen, University Medical Center Groningen]
Jan Willem J Elting,,
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, Jeanette Tas - [University of Groningen, University Medical Center Groningen]
Jeanette Tas,,
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, M.J.H. Aries - [University Hospital Maastricht]
M.J.H. Aries,,
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, Marek Czosnyka (FEIT / PE)
Marek Czosnyka,,
- The Institute of Electronic Systems
, Natasha M Maurits - [University of Groningen, University Medical Center Groningen]
Natasha M Maurits,,
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Journal seriesJournal of Cerebral Blood Flow & Metabolism, ISSN 0271-678X, (A 40 pkt)
Issue year2018
Pages1-15
Publication size in sheets0.7
Keywords in EnglishDynamic cerebral autoregulation; group delay; microvascular transit time; near infrared spectroscopy; transcranial Doppler
ASJC Classification2705 Cardiology and Cardiovascular Medicine; 2728 Clinical Neurology; 2808 Neurology
DOIDOI:10.1177/0271678X18806107
URL https://journals.sagepub.com/doi/10.1177/0271678X18806107
Languageen angielski
File
0271678x18806107.pdf 791.16 KB
Score (nominal)40
ScoreMinisterial score = 40.0, 23-09-2019, ArticleFromJournal
Publication indicators Scopus Citations = 1; Scopus SNIP (Source Normalised Impact per Paper): 2017 = 1.437; WoS Impact Factor: 2017 = 6.045 (2) - 2017=6.03 (5)
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