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 and Schibler, Andreas (2011) Rapid assessment of cerebral autoregulation by near-infrared spectroscopy and a single dose of phenylephrine. Pediatric Research, 69 5: 436-441. doi:10.1203/PDR.0b013e3182110177

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Author Wagner, Bendicht P.
Ammann, Roland A.
Bachmann, Denis C.G.
Born, Susanne
Schibler, Andreas
Title Rapid assessment of cerebral autoregulation by near-infrared spectroscopy and a single dose of phenylephrine
Journal name Pediatric Research   Check publisher's open access policy
ISSN 0031-3998
Publication date 2011-05-01
Year available 2011
Sub-type Article (original research)
DOI 10.1203/PDR.0b013e3182110177
Open Access Status DOI
Volume 69
Issue 5
Start page 436
End page 441
Total pages 6
Place of publication Philadelphia, PA, U.S.A.
Publisher Lippincott Williams & Wilkins
Language eng
Abstract Rapid bedside determination of cerebral blood pressure autoregulation (AR) may improve clinical utility. We tested the hypothesis that cerebral Hb oxygenation (Hb(Diff)) and cerebral Hb volume (Hb(Total)) 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, Delta Hb(Diff) and Delta Hb(Total) 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%, Delta Hb(Diff), and Delta Hb(Total) by the concomitant change in blood pressure. In 24 patients (11 newborns and 13 children), significant correlations between BFI% and Delta Hb(Diff) (or Delta Hb(Total)) were found. In addition, the associations between Hb-based ARI and BFI%-based ART 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. (Pediatr Res 69: 436-441, 2011)
Keyword Pediatrics
Pediatrics
PEDIATRICS
Q-Index Code C1
Q-Index Status Confirmed Code
Grant ID 32-51078.97
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Fri, 25 Nov 2011, 23:05:44 EST by Matthew Lamb on behalf of School of Medicine