Noninvasive monitoring of dynamic cerebrovascular autoregulation and ‘optimal blood pressure’ in normal adult subjects

Paul Pham; Jessica Bindra; Anders Aneman; Alwin Chuan; John M. Worthington; Matthias Jaeger

doi:10.1007/s12028-018-0600-2

Noninvasive monitoring of dynamic cerebrovascular autoregulation and ‘optimal blood pressure’ in normal adult subjects

Paul Pham, Jessica Bindra, Anders Aneman, Alwin Chuan, John M. Worthington, Matthias Jaeger^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Background: Cerebrovascular autoregulation can be continuously monitored from slow fluctuations of arterial blood pressure (ABP) and regional cerebral oxygen saturation (rSO₂). The purpose of this study was to evaluate the index of dynamic cerebrovascular autoregulation (TOx) and the associated ‘optimal’ ABP in normal adult healthy subjects. Methods: Twenty-eight healthy volunteers were studied. TOx was calculated as the moving correlation coefficient between spontaneous fluctuations of ABP and rSO₂. ABP was measured with the Finometer photoplethysmograph. The ABP with optimal autoregulation (ABP_OPT) was also determined as the ABP level with the lowest associated TOx (opt-TOx). Results: Average rSO₂ and TOx was 72.3 ± 2.9% and 0.05 ± 0.18, respectively. Two subjects had impaired autoregulation with a TOx > 0.3. The opt-TOx was − 0.1 ± 0.26. ABP_OPT was 87.0 ± 16.7 mmHg. The difference between ABP and ABP_OPT was − 0.3 ± 7.5 mmHg. In total, 44% of subjects had a deviation of ABP from ABP_OPT exceeding 5 mmHg. ABP_OPT ranged from 57 to 117 mmHg. Conclusions: TOx in healthy volunteers on average displays intact autoregulation and ABP close to ABP_OPT. However, some subjects have possible autoregulatory dysfunction or a significant deviation of ABP from ABP_OPT, which may confer a susceptibility to neurological injury.

Original language	English
Pages (from-to)	201-206
Number of pages	6
Journal	Neurocritical Care
Volume	30
Issue number	1
Early online date	6 Sept 2018
DOIs	https://doi.org/10.1007/s12028-018-0600-2
Publication status	Published - 15 Feb 2019
Externally published	Yes

Keywords

Cerebral autoregulation
Near-infrared spectroscopy
Neuromonitoring
Optimal cerebral perfusion pressure

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10.1007/s12028-018-0600-2

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@article{1036eae025034394923111dd7d25b32d,

title = "Noninvasive monitoring of dynamic cerebrovascular autoregulation and {\textquoteleft}optimal blood pressure{\textquoteright} in normal adult subjects",

abstract = "Background: Cerebrovascular autoregulation can be continuously monitored from slow fluctuations of arterial blood pressure (ABP) and regional cerebral oxygen saturation (rSO2). The purpose of this study was to evaluate the index of dynamic cerebrovascular autoregulation (TOx) and the associated {\textquoteleft}optimal{\textquoteright} ABP in normal adult healthy subjects. Methods: Twenty-eight healthy volunteers were studied. TOx was calculated as the moving correlation coefficient between spontaneous fluctuations of ABP and rSO2. ABP was measured with the Finometer photoplethysmograph. The ABP with optimal autoregulation (ABPOPT) was also determined as the ABP level with the lowest associated TOx (opt-TOx). Results: Average rSO2 and TOx was 72.3 ± 2.9% and 0.05 ± 0.18, respectively. Two subjects had impaired autoregulation with a TOx > 0.3. The opt-TOx was − 0.1 ± 0.26. ABPOPT was 87.0 ± 16.7 mmHg. The difference between ABP and ABPOPT was − 0.3 ± 7.5 mmHg. In total, 44% of subjects had a deviation of ABP from ABPOPT exceeding 5 mmHg. ABPOPT ranged from 57 to 117 mmHg. Conclusions: TOx in healthy volunteers on average displays intact autoregulation and ABP close to ABPOPT. However, some subjects have possible autoregulatory dysfunction or a significant deviation of ABP from ABPOPT, which may confer a susceptibility to neurological injury.",

keywords = "Cerebral autoregulation, Near-infrared spectroscopy, Neuromonitoring, Optimal cerebral perfusion pressure",

author = "Paul Pham and Jessica Bindra and Anders Aneman and Alwin Chuan and Worthington, {John M.} and Matthias Jaeger",

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doi = "10.1007/s12028-018-0600-2",

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T1 - Noninvasive monitoring of dynamic cerebrovascular autoregulation and ‘optimal blood pressure’ in normal adult subjects

AU - Pham, Paul

AU - Bindra, Jessica

AU - Aneman, Anders

AU - Chuan, Alwin

AU - Worthington, John M.

AU - Jaeger, Matthias

PY - 2019/2/15

Y1 - 2019/2/15

N2 - Background: Cerebrovascular autoregulation can be continuously monitored from slow fluctuations of arterial blood pressure (ABP) and regional cerebral oxygen saturation (rSO2). The purpose of this study was to evaluate the index of dynamic cerebrovascular autoregulation (TOx) and the associated ‘optimal’ ABP in normal adult healthy subjects. Methods: Twenty-eight healthy volunteers were studied. TOx was calculated as the moving correlation coefficient between spontaneous fluctuations of ABP and rSO2. ABP was measured with the Finometer photoplethysmograph. The ABP with optimal autoregulation (ABPOPT) was also determined as the ABP level with the lowest associated TOx (opt-TOx). Results: Average rSO2 and TOx was 72.3 ± 2.9% and 0.05 ± 0.18, respectively. Two subjects had impaired autoregulation with a TOx > 0.3. The opt-TOx was − 0.1 ± 0.26. ABPOPT was 87.0 ± 16.7 mmHg. The difference between ABP and ABPOPT was − 0.3 ± 7.5 mmHg. In total, 44% of subjects had a deviation of ABP from ABPOPT exceeding 5 mmHg. ABPOPT ranged from 57 to 117 mmHg. Conclusions: TOx in healthy volunteers on average displays intact autoregulation and ABP close to ABPOPT. However, some subjects have possible autoregulatory dysfunction or a significant deviation of ABP from ABPOPT, which may confer a susceptibility to neurological injury.

AB - Background: Cerebrovascular autoregulation can be continuously monitored from slow fluctuations of arterial blood pressure (ABP) and regional cerebral oxygen saturation (rSO2). The purpose of this study was to evaluate the index of dynamic cerebrovascular autoregulation (TOx) and the associated ‘optimal’ ABP in normal adult healthy subjects. Methods: Twenty-eight healthy volunteers were studied. TOx was calculated as the moving correlation coefficient between spontaneous fluctuations of ABP and rSO2. ABP was measured with the Finometer photoplethysmograph. The ABP with optimal autoregulation (ABPOPT) was also determined as the ABP level with the lowest associated TOx (opt-TOx). Results: Average rSO2 and TOx was 72.3 ± 2.9% and 0.05 ± 0.18, respectively. Two subjects had impaired autoregulation with a TOx > 0.3. The opt-TOx was − 0.1 ± 0.26. ABPOPT was 87.0 ± 16.7 mmHg. The difference between ABP and ABPOPT was − 0.3 ± 7.5 mmHg. In total, 44% of subjects had a deviation of ABP from ABPOPT exceeding 5 mmHg. ABPOPT ranged from 57 to 117 mmHg. Conclusions: TOx in healthy volunteers on average displays intact autoregulation and ABP close to ABPOPT. However, some subjects have possible autoregulatory dysfunction or a significant deviation of ABP from ABPOPT, which may confer a susceptibility to neurological injury.

KW - Cerebral autoregulation

KW - Near-infrared spectroscopy

KW - Neuromonitoring

KW - Optimal cerebral perfusion pressure

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SN - 1541-6933

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SP - 201

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JO - Neurocritical Care

JF - Neurocritical Care

IS - 1

ER -

Noninvasive monitoring of dynamic cerebrovascular autoregulation and ‘optimal blood pressure’ in normal adult subjects

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