Continuous Time-Domain Cerebrovascular Reactivity Metrics and Discriminate Capacity for the Upper and Lower Limits of Autoregulation: A Scoping Review of the Animal Literature.
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Authors
Sainbhi, Amanjyot Singh
Froese, Logan
Gomez, Alwyn
Batson, Carleen
Stein, Kevin Y
Alizadeh, Arsalan
Publication Date
2021Journal Title
Neurotrauma Rep
ISSN
2689-288X
Publisher
Mary Ann Liebert Inc
Volume
2
Issue
1
Pages
639-659
Language
eng
Type
Article
This Version
VoR
Metadata
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Sainbhi, A. S., Froese, L., Gomez, A., Batson, C., Stein, K. Y., Alizadeh, A., & Zeiler, F. A. (2021). Continuous Time-Domain Cerebrovascular Reactivity Metrics and Discriminate Capacity for the Upper and Lower Limits of Autoregulation: A Scoping Review of the Animal Literature.. Neurotrauma Rep, 2 (1), 639-659. https://doi.org/10.1089/neur.2021.0043
Abstract
Over a wide range of systemic arterial pressures, cerebral blood flow (CBF) is regulated fairly constantly by the cerebral vessels in a process termed cerebral autoregulation (CA), which is depicted by the Lassen autoregulatory curve. After traumatic brain injury (TBI), CA can get impaired and these impairments manifest in changes of the Lassen autoregulatory curve. Continuous surrogate metrics of pressure-based CA, termed cerebrovascular reactivity (CVR) metrics, evaluate the relationship between slow vasogenic fluctuations in a driving pressure for cerebral blood flow, and the most commonly studied and utilized measures are based in the time domain and have been increasingly applied in bedside TBI care and have sparked the investigation of individualized cerebral perfusion pressure targets. However, not all CVR metrics have been validated as true measures of autoregulation in the pre-clinical setting. We reviewed all available pre-clinical animal literature that assessed the association between continuous time-domain metrics of CVR and some aspect of the Lassen autoregulatory curve. All 15 articles found associated the evaluated continuous metrics to the lower limit of autoregulation curve whereas none looked at the upper limit. Most of the evaluated metrics showed the ability to discriminate the lower limit of autoregulation with various methods of perturbation. Further work is required to evaluate the utility of such surrogate measures against the upper limit of autoregulation, while also providing validation to the existing literature supporting specific indices and their ability to discriminate the lower limit.
Keywords
Cerebrovascular Autoregulation, Lower Limit Of Autoregulation, Cerebrovascular Reactivity Metrics, Lassen Autoregulatory Curve, Time-Domain Metrics
Identifiers
PMC8742280, 35018365
External DOI: https://doi.org/10.1089/neur.2021.0043
This record's URL: https://www.repository.cam.ac.uk/handle/1810/333966
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