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01.02.2007 | Original

Continuous cerebral autoregulation monitoring by improved cross-correlation analysis: comparison with the cuff deflation test

verfasst von: Melanie Christ, Frank Noack, Tobias Schroeder, Andreas Hagmueller, Rainer Koch, Sven-Axel May, Ute Morgenstern, Maximilian Ragaller, Ralf Steinmeier

Erschienen in: Intensive Care Medicine | Ausgabe 2/2007

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Abstract

Objectives

To improve the cross-correlation method for noninvasive, continuous monitoring of cerebral autoregulation, to evaluate this method in humans with intact and impaired autoregulatory capacity, and to compare it to the cuff deflation test.

Design and setting

Prospective study in the intensive care unit of a university hospital.

Patients and participants

Fourteen patients with severe head injury, six patients with subarachnoid hemorrhage, and nine healthy volunteers.

Interventions and measurements

Middle cerebral artery flow velocities and arterial blood pressure were monitored continuously. Aaslid's thigh cuff tests were performed and results were scored using Tiecks' model for autoregulation index. Data were then collected without any patient manipulation. The mean time delay between slow spontaneous oscillations of blood pressure and middle cerebral artery flow velocity was calculated by cross-correlation analysis. Data are expressed as median (lower/upper quartile).

Results

Healthy subjects had a higher autoregulation index than patients, 5.0 (5.0/5.5) vs. 3.3 (2.0/4.5). Slow oscillations of blood pressure and middle cerebral artery flow velocity showed a time delay of –2.0 s (–2.7/–1.7) in healthy subjects but were almost synchronal in patients, –0.07 s (–0.5/0.45). Inter-method agreement in diagnosing an intact or impaired cerebral autoregulation was obtained in 108 of 147 examinations of autoregulation (73.5%) and was considered moderate.

Conclusions

Cross-correlation analysis may serve as a simple, noninvasive, and continuous measure of cerebral autoregulation. The time delay of –2.0 s in healthy subjects is in good agreement with other studies. Short-term autoregulation tests and monitoring techniques based on slow spontaneous oscillations should not be used interchangeably.

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Titel: Continuous cerebral autoregulation monitoring by improved cross-correlation analysis: comparison with the cuff deflation test
verfasst von: Melanie Christ
Frank Noack
Tobias Schroeder
Andreas Hagmueller
Rainer Koch
Sven-Axel May
Ute Morgenstern
Maximilian Ragaller
Ralf Steinmeier
Publikationsdatum: 01.02.2007
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 2/2007
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-006-0451-8

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Continuous cerebral autoregulation monitoring by improved cross-correlation analysis: comparison with the cuff deflation test