Rapid assessment of cerebral autoregulation by near-infrared spectroscopy and a single dose of phenylephrine

Wagner, Bendicht P; Ammann, Roland A; Bachmann, Denis C G; Born, Susanne; Schibler, Andreas (2011). Rapid assessment of cerebral autoregulation by near-infrared spectroscopy and a single dose of phenylephrine. Pediatric research, 69(5 Pt 1), pp. 436-41. New York, N.Y.: Nature Publishing Group 10.1203/PDR.0b013e3182110177

Full text not available from this repository. (Request a copy)

Rapid bedside determination of cerebral blood pressure autoregulation (AR) may improve clinical utility. We tested the hypothesis that cerebral Hb oxygenation (HbDiff) and cerebral Hb volume (HbTotal) measured by near-infrared spectroscopy (NIRS) would correlate with cerebral blood flow (CBF) after single dose phenylephrine (PE). Critically ill patients requiring artificial ventilation and arterial lines were eligible. During rapid blood pressure rise induced by i.v. PE bolus, ΔHbDiff and ΔHbTotal were calculated by subtracting values at baseline (normotension) from values at peak blood pressure elevation (hypertension). With the aid of NIRS and bolus injection of indocyanine green, relative measures of CBF, called blood flow index (BFI), were determined during normotension and during hypertension. BFI during hypertension was expressed as percentage from BFI during normotension (BFI%). Autoregulation indices (ARIs) were calculated by dividing BFI%, ΔHbDiff, and ΔHbTotal by the concomitant change in blood pressure. In 24 patients (11 newborns and 13 children), significant correlations between BFI% and ΔHbDiff (or ΔHbTotal) were found. In addition, the associations between Hb-based ARI and BFI%-based ARI were significant with correlation coefficients of 0.73 (or 0.72). Rapid determination of dynamic AR with the aid of cerebral Hb signals and PE bolus seems to be reliable.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine

UniBE Contributor:

Wagner, Bendicht Peter; Ammann, Roland and Bachmann, Denis

ISSN:

0031-3998

Publisher:

Nature Publishing Group

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:24

Last Modified:

17 Mar 2015 21:04

Publisher DOI:

10.1203/PDR.0b013e3182110177

PubMed ID:

21258266

Web of Science ID:

000289811000012

URI:

https://boris.unibe.ch/id/eprint/8335 (FactScience: 213856)

Actions (login required)

Edit item Edit item
Provide Feedback