Academic Journal
Noninvasive Monitoring of Cerebrovascular Reactivity with Near Infrared Spectroscopy in Head-Injured Patients
| Title: | Noninvasive Monitoring of Cerebrovascular Reactivity with Near Infrared Spectroscopy in Head-Injured Patients |
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| Authors: | Zweifel, Christian, Castellani, Gianluca, Czosnyka, Marek, Helmy, Adel, Manktelow, Anne, Carrera, Emmanuel, Brady, Kenneth M, Hutchinson, Peter J A, Menon, David K, Pickard, John D, Smielewski, Peter |
| Source: | Journal of Neurotrauma, Vol. 27, No 11 (2010) pp. 1951-1958 |
| Publisher Information: | Mary Ann Liebert Inc, 2010. |
| Publication Year: | 2010 |
| Subject Terms: | Adult, Male, Spectroscopy, Near-Infrared/methods, Critical Care, Intracranial Pressure, Cerebrovascular Circulation/physiology, Glasgow Outcome Scale, Blood Pressure, Young Adult, Hemoglobins, 03 medical and health sciences, 0302 clinical medicine, Head Injuries, Closed, Homeostasis, Humans, Glasgow Coma Scale, Hospital Mortality, Blood Pressure/physiology, Monitoring, Physiologic, Hemoglobins/metabolism, Homeostasis/physiology, Brain Injuries/pathology, Electroencephalography, Middle Aged, Head Injuries, Closed/physiopathology, ROC Curve, Brain Injuries, Cerebrovascular Circulation, Data Interpretation, Statistical, Linear Models, Female, Intracranial Pressure/physiology, Signal Transduction |
| Description: | Monitoring of cerebrovascular pressure reactivity (PRx) has diagnostic and prognostic value in head-injured patients, but requires invasive monitoring of intracranial pressure (ICP). Near infrared spectroscopy (NIRS) is a noninvasive method that is suitable for continuous detection of cerebral blood volume changes. We compared a NIRS-based index of cerebrovascular reactivity, called total hemoglobin reactivity (THx), against standard measurements of PRx in a prospective observational study. Forty patients with closed-head injury were monitored daily with arterial blood pressure (ABP), ICP, and a NIRS-based total hemoglobin index. PRx and THx were calculated as the moving correlation coefficients using 5-min time windows between 10-sec averaged values of ICP and ABP, and total hemoglobin index and ABP, respectively. A total of 120 recordings were performed between the median first (IQR 0.75-2) and fourth (IQR 2-6) day after head injury, giving a total duration of 1760 hours. PRx and THx demonstrated a significant association across averaged individual recordings (r = 0.49, p < 0.0001), and across patients (r = 0.56, p = 0.0002). Assessment of optimal cerebral perfusion pressure (CPP) and ABP using THx was possible in about 50% of recordings, and showed a significant agreement with the optimal CPP and ABP assessed with PRx. THx may be of diagnostic value to optimize therapy oriented toward restoration and continuity of cerebrovascular reactivity, especially in patients for whom direct ICP monitoring is not feasible. |
| Document Type: | Article |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1557-9042 0897-7151 |
| DOI: | 10.1089/neu.2010.1388 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/20812789 https://www.liebertpub.com/doi/10.1089/neu.2010.1388?rfr_id=ori:rid:crossref.org https://www.scholars.northwestern.edu/en/publications/noninvasive-monitoring-of-cerebrovascular-reactivity-with-near-in http://www.liebertpub.com/doi/10.1089/neu.2010.1388 https://online.liebertpub.com/doi/abs/10.1089/neu.2010.1388 https://pubmed.ncbi.nlm.nih.gov/20812789/ http://www.ncbi.nlm.nih.gov/pubmed/20812789 https://archive-ouverte.unige.ch/unige:152323 |
| Rights: | Mary Ann Liebert TDM |
| Accession Number: | edsair.doi.dedup.....35db383676badc90a31cf0420e4ab4a6 |
| Database: | OpenAIRE |
| ISSN: | 15579042 08977151 |
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| DOI: | 10.1089/neu.2010.1388 |