Abstract
Impaired cerebral autoregulation (CA) is common and is associated with brain damage in sick neonates. Frequency analysis using spontaneous changes in arterial blood pressure (ABP) and cerebral near-infrared spectroscopy (NIRS) has been used to measure CA in several clinical studies. Coherence of the NIRS and ABP signals (i.e. correlation in the frequency domain) detects impairment of CA, whereas gain (i.e. magnitude of ABP variability passing from systemic to cerebral circulation) estimates the degree of this impairment. So far, however, this method has not been validated. In 12 newborn piglets, we compared NIRS-derived measures of CA with a conventional measure of CA: cerebral blood flow was measured by laser Doppler flowmetry, and changes in ABP were induced by inflating a thoracic aorta balloon. CA capacity was calculated as %ΔCVR/%ΔABP (i.e. percentage of full autoregulatory capacity), where CVR (i.e. cerebral vascular resistance) was estimated as ABP/Doppler flux. Correlation between coherence and CA capacity (r = −0.34, n = 24, p > 0.05) and between gain and CA capacity (r = −0.11, n = 24, p > 0.05) was limited. As expected, however, gain was significantly associated with CA capacity in measurements with significant coherence (r = −0.55, n = 15, p = 0.03). In conclusion, our data validate frequency analysis for estimation of CA in clinical research. Low precision, however, hampers its clinical application.
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Abbreviations
- ABP:
-
arterial blood pressure
- CA:
-
cerebral autoregulation
- CBF:
-
cerebral blood flow
- CVR:
-
cerebrovascular resistance
- CVRe:
-
estimated cerebrovascular resistance
- IVH:
-
intraventricular hemorrhage
- LDF:
-
laser Doppler flowmetry
- LF:
-
low frequency (0.003–0.04 Hz)
- MAP:
-
mean arterial blood pressure
- NIRS:
-
near-infrared spectroscopy
- OI:
-
oxygenation index
- PSD:
-
power spectral density
- VLF:
-
very low frequency (0.04–0.1 Hz)
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Acknowledgements
We thank animal health technicians Letty Klarskov and Mette Værum Olesen for their practical help in the experiments. We also thank Senior Research Fellow Terence Leung, Ph.D., from Department of Medical Physics and Bioengineering, University College, London, for programming the software used to carry out the signal analysis.
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Supported by the Ludvig and Sara Elsass Foundation and the University of Copenhagen, Denmark.
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Hahn, G., Heiring, C., Pryds, O. et al. Applicability of Near-Infrared Spectroscopy to Measure Cerebral Autoregulation Noninvasively in Neonates: A Validation Study in Piglets. Pediatr Res 70, 166–170 (2011). https://doi.org/10.1203/PDR.0b013e3182231d9e
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DOI: https://doi.org/10.1203/PDR.0b013e3182231d9e
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