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, Marcel J.H. Aries, Marek Czosnyka, Natasha M. Maurits

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

21 Citaten (Scopus)
221 Downloads (Pure)

Samenvatting

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 degrees vs. 30.7 degrees, right: intraclass correlation=0.56, median phase difference 32.6 degrees vs. 39.8 degrees) and mild hypocapnia (left: intraclass correlation=0.73, median phase difference 48.6 degrees vs. 43.3 degrees, right: intraclass correlation=0.70, median phase difference 52.1 degrees vs. 61.8 degrees). 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.

Originele taal-2English
Pagina's (van-tot)135-149
Aantal pagina's15
TijdschriftJournal of Cerebral Blood Flow and Metabolism
Volume40
Nummer van het tijdschrift1
Vroegere onlinedatum24-okt.-2018
DOI's
StatusPublished - jan.-2020
EvenementJournal-of-Cerebral-Blood-Flow-and-Metabolism (JCBFM) Symposium at International Symposium on Cerebral Blood Flow, Metabolism and Function (BRAIN) - Yokohama, Japan
Duur: 7-jul.-2019 → …

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