Comparison of wavelet and correlation indices of cerebral autoregulation in a pediatric swine model of cardiac arrest.
Brady, Ken M
Lee, Jennifer K
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Liu, X., Hu, X., Brady, K. M., Koehler, R., Smielewski, P., Czosnyka, M., Donnelly, J., & et al. (2020). Comparison of wavelet and correlation indices of cerebral autoregulation in a pediatric swine model of cardiac arrest.. Scientific reports, 10 (1)https://doi.org/10.1038/s41598-020-62435-8
Existing cerebrovascular blood pressure autoregulation metrics have not been translated to clinical care for pediatric cardiac arrest, in part because signal noise causes high index time-variability. We tested whether a wavelet method that uses near-infrared spectroscopy (NIRS) or intracranial pressure (ICP) decreases index variability compared to that of commonly used correlation indices. We also compared whether the methods identify the optimal arterial blood pressure (ABPopt) and lower limit of autoregulation (LLA). 68 piglets were randomized to cardiac arrest or sham procedure with continuous monitoring of cerebral blood flow using laser Doppler, NIRS and ICP. The arterial blood pressure (ABP) was gradually reduced until it dropped to below the LLA. Several autoregulation indices were calculated using correlation and wavelet methods, including the pressure reactivity index (PRx and wPRx), cerebral oximetry index (COx and wCOx), and hemoglobin volume index (HVx and wHVx). Wavelet methodology had less index variability with smaller standard deviations. Both wavelet and correlation methods distinguished functional autoregulation (ABP above LLA) from dysfunctional autoregulation (ABP below the LLA). Both wavelet and correlation methods also identified ABPopt with high agreement. Thus, wavelet methodology using NIRS may offer an accurate vasoreactivity monitoring method with reduced signal noise after pediatric cardiac arrest.
NHLBI NIH HHS (R01 HL139543)
NINDS NIH HHS (R21 NS095036, R01 NS076738, R01 NS106905, R01 NS060703, R01 NS107417, K08 NS080984)
External DOI: https://doi.org/10.1038/s41598-020-62435-8
This record's URL: https://www.repository.cam.ac.uk/handle/1810/305040
Attribution 4.0 International
Licence URL: https://creativecommons.org/licenses/by/4.0/