Cerebrovascular Autoregulation in Preterm Infants Using Heart Rate or Blood Pressure: A Pilot Study

Bineta E Lahr; Celina L Brunsch; Riksta Dikkers; Arend F Bos; Elisabeth M W Kooi

doi:10.3390/children11070765

Cerebrovascular Autoregulation in Preterm Infants Using Heart Rate or Blood Pressure: A Pilot Study

Bineta E Lahr, Celina L Brunsch, Riksta Dikkers, Arend F Bos, Elisabeth M W Kooi^*

^*Corresponding author for this work

Reproductive Origins of Adult Health and Disease (ROAHD)

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Abstract

BACKGROUND: Cerebrovascular autoregulation (CAR) is often impaired in preterm infants but requires invasive mean arterial blood pressure (MABP) measurements for continuous assessment. We aimed to assess whether using heart rate (HR) results in different CAR assessment compared with using MABP.

METHODS: We compared CAR (moving window correlation-coefficient with cerebral oxygenation saturation (r cSO 2)), and percentage of time with impaired CAR (%timeCARi) calculated by either HR (TOHRx, tissue oxygenation heart rate reactivity index) or MABP (COx, cerebral oximetry index) during the first 72 h after birth, and its association with short-term cerebral injury.

RESULTS: We included 32 infants, median gestational age of 25 + 5/7 weeks (interquartile range 24 + 6/7-27 + 5/7). COx and TOHRx correlation coefficients (cc) were significantly different in the first two days after birth (individual means ranging from 0.02 to 0.07 and -0.05 to 0.01). %TimeCARi using MABP (cc cut-off 0.3), was higher on day 1 (26.1% vs. 17.7%) and day 3 (23.4% vs. 16.9%) compared with HR (cc cutoff -0.3). During 65.7-69.6% of the time, both methods indicated impaired CAR simultaneously. The aforementioned calculations were not associated with early cerebral injury.

CONCLUSIONS: In conclusion, HR and MABP do not seem interchangeable when assessing CAR in preterm infants.

Original language	English
Article number	765
Number of pages	12
Journal	Children
Volume	11
Issue number	7
DOIs	https://doi.org/10.3390/children11070765
Publication status	Published - 24-Jun-2024

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@article{673730c860264cf0a1cca5a7419d5f6b,

title = "Cerebrovascular Autoregulation in Preterm Infants Using Heart Rate or Blood Pressure: A Pilot Study",

abstract = "BACKGROUND: Cerebrovascular autoregulation (CAR) is often impaired in preterm infants but requires invasive mean arterial blood pressure (MABP) measurements for continuous assessment. We aimed to assess whether using heart rate (HR) results in different CAR assessment compared with using MABP.METHODS: We compared CAR (moving window correlation-coefficient with cerebral oxygenation saturation (r cSO 2)), and percentage of time with impaired CAR (%timeCARi) calculated by either HR (TOHRx, tissue oxygenation heart rate reactivity index) or MABP (COx, cerebral oximetry index) during the first 72 h after birth, and its association with short-term cerebral injury. RESULTS: We included 32 infants, median gestational age of 25 + 5/7 weeks (interquartile range 24 + 6/7-27 + 5/7). COx and TOHRx correlation coefficients (cc) were significantly different in the first two days after birth (individual means ranging from 0.02 to 0.07 and -0.05 to 0.01). %TimeCARi using MABP (cc cut-off 0.3), was higher on day 1 (26.1% vs. 17.7%) and day 3 (23.4% vs. 16.9%) compared with HR (cc cutoff -0.3). During 65.7-69.6% of the time, both methods indicated impaired CAR simultaneously. The aforementioned calculations were not associated with early cerebral injury.CONCLUSIONS: In conclusion, HR and MABP do not seem interchangeable when assessing CAR in preterm infants.",

author = "Lahr, {Bineta E} and Brunsch, {Celina L} and Riksta Dikkers and Bos, {Arend F} and Kooi, {Elisabeth M W}",

year = "2024",

month = jun,

day = "24",

doi = "10.3390/children11070765",

language = "English",

volume = "11",

journal = "Children",

issn = "2227-9067",

publisher = "MDPI AG",

number = "7",

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TY - JOUR

T1 - Cerebrovascular Autoregulation in Preterm Infants Using Heart Rate or Blood Pressure

T2 - A Pilot Study

AU - Lahr, Bineta E

AU - Brunsch, Celina L

AU - Dikkers, Riksta

AU - Bos, Arend F

AU - Kooi, Elisabeth M W

PY - 2024/6/24

Y1 - 2024/6/24

N2 - BACKGROUND: Cerebrovascular autoregulation (CAR) is often impaired in preterm infants but requires invasive mean arterial blood pressure (MABP) measurements for continuous assessment. We aimed to assess whether using heart rate (HR) results in different CAR assessment compared with using MABP.METHODS: We compared CAR (moving window correlation-coefficient with cerebral oxygenation saturation (r cSO 2)), and percentage of time with impaired CAR (%timeCARi) calculated by either HR (TOHRx, tissue oxygenation heart rate reactivity index) or MABP (COx, cerebral oximetry index) during the first 72 h after birth, and its association with short-term cerebral injury. RESULTS: We included 32 infants, median gestational age of 25 + 5/7 weeks (interquartile range 24 + 6/7-27 + 5/7). COx and TOHRx correlation coefficients (cc) were significantly different in the first two days after birth (individual means ranging from 0.02 to 0.07 and -0.05 to 0.01). %TimeCARi using MABP (cc cut-off 0.3), was higher on day 1 (26.1% vs. 17.7%) and day 3 (23.4% vs. 16.9%) compared with HR (cc cutoff -0.3). During 65.7-69.6% of the time, both methods indicated impaired CAR simultaneously. The aforementioned calculations were not associated with early cerebral injury.CONCLUSIONS: In conclusion, HR and MABP do not seem interchangeable when assessing CAR in preterm infants.

AB - BACKGROUND: Cerebrovascular autoregulation (CAR) is often impaired in preterm infants but requires invasive mean arterial blood pressure (MABP) measurements for continuous assessment. We aimed to assess whether using heart rate (HR) results in different CAR assessment compared with using MABP.METHODS: We compared CAR (moving window correlation-coefficient with cerebral oxygenation saturation (r cSO 2)), and percentage of time with impaired CAR (%timeCARi) calculated by either HR (TOHRx, tissue oxygenation heart rate reactivity index) or MABP (COx, cerebral oximetry index) during the first 72 h after birth, and its association with short-term cerebral injury. RESULTS: We included 32 infants, median gestational age of 25 + 5/7 weeks (interquartile range 24 + 6/7-27 + 5/7). COx and TOHRx correlation coefficients (cc) were significantly different in the first two days after birth (individual means ranging from 0.02 to 0.07 and -0.05 to 0.01). %TimeCARi using MABP (cc cut-off 0.3), was higher on day 1 (26.1% vs. 17.7%) and day 3 (23.4% vs. 16.9%) compared with HR (cc cutoff -0.3). During 65.7-69.6% of the time, both methods indicated impaired CAR simultaneously. The aforementioned calculations were not associated with early cerebral injury.CONCLUSIONS: In conclusion, HR and MABP do not seem interchangeable when assessing CAR in preterm infants.

U2 - 10.3390/children11070765

DO - 10.3390/children11070765

M3 - Article

C2 - 39062215

SN - 2227-9067

VL - 11

JO - Children

JF - Children

IS - 7

M1 - 765

ER -

Cerebrovascular Autoregulation in Preterm Infants Using Heart Rate or Blood Pressure: A Pilot Study

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