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.
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Publication Date
2020-01Journal Title
J Cereb Blood Flow Metab
ISSN
0271-678X
Publisher
SAGE Publications
Volume
40
Issue
1
Pages
135-149
Language
eng
Type
Article
This Version
VoR
Physical Medium
Print-Electronic
Metadata
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Elting, J. W. J., Tas, J., Aries, M. J., Czosnyka, M., & Maurits, N. M. (2020). 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.. J Cereb Blood Flow Metab, 40 (1), 135-149. https://doi.org/10.1177/0271678X18806107
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.
Keywords
Humans, Hypercapnia, Hypocapnia, Oxyhemoglobins, Ultrasonography, Doppler, Transcranial, Spectroscopy, Near-Infrared, Blood Flow Velocity, Homeostasis, Blood Volume, Blood Pressure, Cerebrovascular Circulation, Rest, Adult, Female, Male, Hemodynamics
Identifiers
External DOI: https://doi.org/10.1177/0271678X18806107
This record's URL: https://www.repository.cam.ac.uk/handle/1810/286983
Rights
Attribution-NonCommercial 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc/4.0/
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