Assessment of cerebral hemodynamic parameters using pulsatile versus non-pulsatile cerebral blood outflow models

Agnieszka Uryga , Magdalena Kasprowicz , Leanne Calviello , R.R Diehl , Katarzyna Kaczmarska , Marek Czosnyka


Background: Prior methods evaluating the changes in cerebral arterial blood volume (∆CaBV) assumed that brain blood transport distal to big cerebral arteries can be approximated with a non-pulsatile flow (CFF) model. In this study, a modified ∆CaBV calculation that accounts for pulsatile blood flow forward (PFF) from large cerebral arteries to resistive arterioles was investigated. The aim was to assess cerebral hemodynamic indices estimated by both CFF and PFF models while changing arterial blood carbon dioxide concentration (EtCO2) in healthy volunteers. Materials and methods: Continuous recordings of non-invasive arterial blood pressure (ABP), transcranial Doppler blood flow velocity (CBFVa), and EtCO2were performed in 53 young volunteers at baseline and during both hypo- and hypercapnia. The time constant of the cerebral arterial bed (τ) and critical closing pressure (CrCP) were estimated using mathematical transformations of the pulse waveforms of ABP and CBFVa, and with both pulsatile and non-pulsatile models of ∆CaBV estimation. Results are presented as median values ± interquartile range. Results: Both CrCP and τ gave significantly lower values with the PFF model when compared with the CFF model (p ≪ 0.001 for both). In comparison to normocapnia, both CrCP and τ determined with the PFF model increased during hypocapnia [CrCPPFF(mm Hg): 5.52 ± 8.78 vs. 14.36 ± 14.47, p = 0.00006; τPFF(ms): 47.4 ± 53.9 vs. 72.8 ± 45.7, p = 0.002] and decreased during hypercapnia [CrCPPFF(mm Hg): 5.52 ± 8.78 vs. 2.36 ± 7.05, p = 0.0001; τPFF(ms): 47.4 ± 53.9 vs. 29.0 ± 31.3, p = 0.0003]. When the CFF model was applied, no changes were found for CrCP during hypercapnia or in τ during hypocapnia. Conclusion: Our results suggest that the pulsatile flow forward model better reflects changes in CrCP and in τ induced by controlled alterations in EtCO2.
Author Agnieszka Uryga - [Wrocław University of Science and Technology]
Agnieszka Uryga,,
, Magdalena Kasprowicz - [Wrocław University of Science and Technology]
Magdalena Kasprowicz,,
, Leanne Calviello - [University of Cambridge]
Leanne Calviello,,
, R.R Diehl - [Alfried Krupp Krankenhaus]
R.R Diehl,,
, Katarzyna Kaczmarska (FEIT / PE)
Katarzyna Kaczmarska,,
- The Institute of Electronic Systems
, Marek Czosnyka (FEIT / PE)
Marek Czosnyka,,
- The Institute of Electronic Systems
Issue year2019
Publication size in sheets0.5
ASJC Classification2703 Anesthesiology and Pain Medicine; 2706 Critical Care and Intensive Care Medicine; 2718 Health Informatics
Languageen angielski
Uryga_assesement_JCMC.pdf 965.5 KB
Score (nominal)70
Score sourcejournalList
ScoreMinisterial score = 70.0, 31-01-2020, ArticleFromJournal
Publication indicators Scopus Citations = 2; WoS Citations = 0; Scopus SNIP (Source Normalised Impact per Paper): 2018 = 0.924; WoS Impact Factor: 2018 = 2.179 (2) - 2018=1.935 (5)
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