6533b823fe1ef96bd127f66f

RESEARCH PRODUCT

Exploring metrics for the characterization of the cerebral autoregulation during head-up tilt and propofol general anesthesia

Vlasta BaripLorenzo BarbarossaFrancesca GelpiBeatrice CairoBeatrice De MariaDavide TononGianluca RossatoLuca FaesMarco RanucciRiccardo BarbieriAlberto Porta

subject

AdultMaleUltrasonography Doppler TranscranialEndocrine and Autonomic SystemsAutoregulation indexBlood PressureSpontaneous variability; Cerebral blood flow; Mean arterial pressure; Cardiovascular control; Autoregulation index; Autonomic nervous systemAnesthesia GeneralMiddle AgedCerebral blood flowMean arterial pressureYoung AdultCellular and Molecular NeuroscienceCerebrovascular CirculationCardiovascular controlSettore ING-INF/06 - Bioingegneria Elettronica e InformaticaHomeostasisHumansAutonomic nervous systemNeurology (clinical)PropofolBlood Flow VelocitySpontaneous variabilityAged

description

Techniques grounded on the simultaneous utilization of Tiecks' second order differential equations and spontaneous variability of mean arterial pressure (MAP) and mean cerebral blood flow velocity (MCBFV), recorded from middle cerebral arteries through a transcranial Doppler device, provide a characterization of cerebral autoregulation (CA) via the autoregulation index (ARI). These methods exploit two metrics for comparing the measured MCBFV series with the version predicted by Tiecks' model: normalized mean square prediction error (NMSPE) and normalized correlation rho. The aim of this study is to assess the two metrics for ARI computation in 13 healthy subjects (age: 27 & PLUSMN; 8 yrs., 5 males) at rest in supine position (REST) and during 60 head-up tilt (HUT) and in 19 patients (age: 64 & PLUSMN; 8 yrs., all males), scheduled for coronary artery bypass grafting, before (PRE) and after (POST) propofol general anesthesia induction. Analyses were carried out over the original MAP and MCBFV pairs and surrogate unmatched couples built individually via time-shifting procedure. We found that: i) NMSPE and rho metrics exhibited similar performances in passing individual surrogate test; ii) the two metrics could lead to different ARI estimates; iii) CA was not different during HUT or POST compared to baseline and this conclusion held regardless of the technique and metric for ARI estimation. Results suggest a limited impact of the sympathetic control on CA.

yearjournalcountryeditionlanguage
2022-11-01
10.1016/j.autneu.2022.103011https://hdl.handle.net/2434/946351