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Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?
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Elting, Jan Willem
Sanders, Marit L.
Panerai, Ronney B.
Aries, Marcel
Bor-Seng-Shu, Edson
Caicedo Dorado, Alexander
Chacon, Max
Gommer, Erik D.
Van Huffel, Sabine
Jara, José L.
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2020
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Public Library of Science
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Abstract
We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured twice in 75 healthy subjects. DCA was analyzed by 14 different centers with a variety of different analysis methods. Intraclass Correlation (ICC) values increased significantly when subjects with low power spectral density MABP (PSD-MABP) values were removed from the analysis for all gain, phase and autoregulation index (ARI) parameters. Gain in the low frequency band (LF) had the highest ICC, followed by phase LF and gain in the very low frequency band. No significant differences were found between analysis methods for gain parameters, but for phase and ARI parameters, significant differences between the analysis methods were found. Alternatively, the Spearman-Brown prediction formula indicated that prolongation of the measurement duration up to 35 minutes may be needed to achieve good reproducibility for some DCA parameters. We conclude that poor DCA reproducibility (ICC and lt;0.4) can improve to good (ICC and gt; 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased. © 2020 Elting et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Keywords
Adult , Article , Autoregulation , Blood flow velocity , Blood pressure variability , Bootstrapping , Brain blood flow , Controlled study , End tidal carbon dioxide tension , Female , Human , Human experiment , Intermethod comparison , Major clinical study , Male , Mean arterial pressure , Prediction , Reproducibility , Spectroscopy , Aged , Arterial pressure , Blood pressure , Blood pressure measurement , Brain circulation , Clinical trial , Homeostasis , Middle aged , Middle cerebral artery , Multicenter study , Normal human , Pathophysiology , Physiology , Procedures , Reproducibility , Adult , Aged , Arterial pressure , Blood flow velocity , Blood pressure , Blood pressure determination , Cerebrovascular circulation , Female , Healthy volunteers , Homeostasis , Humans , Male , Middle aged , Middle cerebral artery , Reproducibility of results
