Cerebral Autoregulation Monitoring with Ultrasound-Tagged Near-Infrared Spectroscopy in Cardiac Surgery Patients

Anesthesia and Analgesia
Daijiro HoriKaushik Mandal

Abstract

Individualizing mean arterial blood pressure (MAP) based on cerebral blood flow (CBF) autoregulation monitoring during cardiopulmonary bypass (CPB) holds promise as a strategy to optimize organ perfusion. The purpose of this study was to evaluate the accuracy of cerebral autoregulation monitoring using microcirculatory flow measured with innovative ultrasound-tagged near-infrared spectroscopy (UT-NIRS) noninvasive technology compared with transcranial Doppler (TCD). Sixty-four patients undergoing CPB were monitored with TCD and UT-NIRS (CerOx™). The mean velocity index (Mx) was calculated as a moving, linear correlation coefficient between slow waves of TCD-measured CBF velocity and MAP. The cerebral flow velocity index (CFVx) was calculated as a similar coefficient between slow waves of cerebral flow index measured using UT-NIRS and MAP. When MAP is outside the autoregulation range, Mx is progressively more positive. Optimal blood pressure was defined as the MAP with the lowest Mx and CFVx. The right- and left-sided optimal MAP values were averaged to define the individual optimal MAP and were the variables used for analysis. The Mx for the left side was 0.31 ± 0.17 and for the right side was 0.32 ± 0.17. The mean CFVx for the...Continue Reading

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Citations

Aug 16, 2016·Anesthesiology Clinics·Matthew A Kirkman, Martin Smith
Aug 30, 2016·PloS One·Adi TsalachMoshe Kamar
Apr 7, 2017·Anesthesiology·Lucia Rivera-LaraMarek A Mirski
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Oct 21, 2015·Anesthesia and Analgesia·Ken BradyR Blaine Easley
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Aug 24, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Benjamin MilneGudrun Kunst
Oct 8, 2021·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Markus Harboe OlsenKirsten Møller

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