Comparison of wavelet and correlation indices of cerebral autoregulation in a pediatric swine model of cardiac arrest

Existing cerebrovascular blood pressure autoregulation metrics have not been translated to clinical care for pediatric cardiac arrest, in part because signal noise causes high index time-variability. We tested whether a wavelet method that uses near-infrared spectroscopy (NIRS) or intracranial press...

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Published inScientific reports Vol. 10; no. 1; p. 5926
Main Authors Liu, Xiuyun, Hu, Xiao, Brady, Ken M., Koehler, Raymond, Smielewski, Peter, Czosnyka, Marek, Donnelly, Joseph, Lee, Jennifer K.
Format Journal Article
LanguageEnglish
Published London Nature Publishing Group UK 03.04.2020
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Abstract Existing cerebrovascular blood pressure autoregulation metrics have not been translated to clinical care for pediatric cardiac arrest, in part because signal noise causes high index time-variability. We tested whether a wavelet method that uses near-infrared spectroscopy (NIRS) or intracranial pressure (ICP) decreases index variability compared to that of commonly used correlation indices. We also compared whether the methods identify the optimal arterial blood pressure (ABPopt) and lower limit of autoregulation (LLA). 68 piglets were randomized to cardiac arrest or sham procedure with continuous monitoring of cerebral blood flow using laser Doppler, NIRS and ICP. The arterial blood pressure (ABP) was gradually reduced until it dropped to below the LLA. Several autoregulation indices were calculated using correlation and wavelet methods, including the pressure reactivity index (PRx and wPRx), cerebral oximetry index (COx and wCOx), and hemoglobin volume index (HVx and wHVx). Wavelet methodology had less index variability with smaller standard deviations. Both wavelet and correlation methods distinguished functional autoregulation (ABP above LLA) from dysfunctional autoregulation (ABP below the LLA). Both wavelet and correlation methods also identified ABPopt with high agreement. Thus, wavelet methodology using NIRS may offer an accurate vasoreactivity monitoring method with reduced signal noise after pediatric cardiac arrest.
AbstractList Existing cerebrovascular blood pressure autoregulation metrics have not been translated to clinical care for pediatric cardiac arrest, in part because signal noise causes high index time-variability. We tested whether a wavelet method that uses near-infrared spectroscopy (NIRS) or intracranial pressure (ICP) decreases index variability compared to that of commonly used correlation indices. We also compared whether the methods identify the optimal arterial blood pressure (ABPopt) and lower limit of autoregulation (LLA). 68 piglets were randomized to cardiac arrest or sham procedure with continuous monitoring of cerebral blood flow using laser Doppler, NIRS and ICP. The arterial blood pressure (ABP) was gradually reduced until it dropped to below the LLA. Several autoregulation indices were calculated using correlation and wavelet methods, including the pressure reactivity index (PRx and wPRx), cerebral oximetry index (COx and wCOx), and hemoglobin volume index (HVx and wHVx). Wavelet methodology had less index variability with smaller standard deviations. Both wavelet and correlation methods distinguished functional autoregulation (ABP above LLA) from dysfunctional autoregulation (ABP below the LLA). Both wavelet and correlation methods also identified ABPopt with high agreement. Thus, wavelet methodology using NIRS may offer an accurate vasoreactivity monitoring method with reduced signal noise after pediatric cardiac arrest.
Existing cerebrovascular blood pressure autoregulation metrics have not been translated to clinical care for pediatric cardiac arrest, in part because signal noise causes high index time-variability. We tested whether a wavelet method that uses near-infrared spectroscopy (NIRS) or intracranial pressure (ICP) decreases index variability compared to that of commonly used correlation indices. We also compared whether the methods identify the optimal arterial blood pressure (ABPopt) and lower limit of autoregulation (LLA). 68 piglets were randomized to cardiac arrest or sham procedure with continuous monitoring of cerebral blood flow using laser Doppler, NIRS and ICP. The arterial blood pressure (ABP) was gradually reduced until it dropped to below the LLA. Several autoregulation indices were calculated using correlation and wavelet methods, including the pressure reactivity index (PRx and wPRx), cerebral oximetry index (COx and wCOx), and hemoglobin volume index (HVx and wHVx). Wavelet methodology had less index variability with smaller standard deviations. Both wavelet and correlation methods distinguished functional autoregulation (ABP above LLA) from dysfunctional autoregulation (ABP below the LLA). Both wavelet and correlation methods also identified ABPopt with high agreement. Thus, wavelet methodology using NIRS may offer an accurate vasoreactivity monitoring method with reduced signal noise after pediatric cardiac arrest.
ArticleNumber 5926
Author Liu, Xiuyun
Donnelly, Joseph
Koehler, Raymond
Lee, Jennifer K.
Brady, Ken M.
Smielewski, Peter
Hu, Xiao
Czosnyka, Marek
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/32245979$$D View this record in MEDLINE/PubMed
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Snippet Existing cerebrovascular blood pressure autoregulation metrics have not been translated to clinical care for pediatric cardiac arrest, in part because signal...
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SubjectTerms 631/378
692/308
692/617
Animals
Arterial Pressure - physiology
Blood flow
Blood pressure
Cardiac arrest
Cerebral blood flow
Cerebrovascular Circulation - physiology
Child
Disease Models, Animal
Heart
Heart Arrest - complications
Heart Arrest - physiopathology
Hemoglobin
Hemoglobins - analysis
Homeostasis - physiology
Humanities and Social Sciences
Humans
Hypoxia, Brain - diagnosis
Hypoxia, Brain - etiology
Hypoxia, Brain - physiopathology
Infrared spectroscopy
Intracranial Pressure - physiology
Laser-Doppler Flowmetry
Male
Monitoring methods
multidisciplinary
Neurophysiological Monitoring - methods
Oximetry - methods
Pediatrics
Science
Science (multidisciplinary)
Spectroscopy, Near-Infrared
Swine
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Title Comparison of wavelet and correlation indices of cerebral autoregulation in a pediatric swine model of cardiac arrest
URI https://link.springer.com/article/10.1038/s41598-020-62435-8
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Volume 10
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