Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands.
School for Mental Health and Neuroscience (MHeNS), University Maastricht, 6229 HX Maastricht, The Netherlands.
Cells. 2022 Jul 21;11(14):2254. doi: 10.3390/cells11142254.
Impairments in cerebral autoregulation (CA) are related to poor clinical outcome. Near infrared spectroscopy (NIRS) is a non-invasive technique applied to estimate CA. Our general purpose was to study the clinical feasibility of a previously published 'NIRS-only' CA methodology in a critically ill intensive care unit (ICU) population and determine its relationship with clinical outcome. Bilateral NIRS measurements were performed for 1-2 h. Data segments of ten-minutes were used to calculate transfer function analyses (TFA) CA estimates between high frequency oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) signals. The phase shift was corrected for serial time shifts. Criteria were defined to select TFA phase plot segments (segments) with 'high-pass filter' characteristics. In 54 patients, 490 out of 729 segments were automatically selected (67%). In 34 primary neurology patients the median (q1-q3) low frequency (LF) phase shift was higher in 19 survivors compared to 15 non-survivors (13° (6.3-35) versus 0.83° (-2.8-13), = 0.0167). CA estimation using the NIRS-only methodology seems feasible in an ICU population using segment selection for more robust and consistent CA estimations. The 'NIRS-only' methodology needs further validation, but has the advantage of being non-invasive without the need for arterial blood pressure monitoring.
大脑自动调节功能（CA）障碍与临床预后不良有关。近红外光谱（NIRS）是一种用于评估 CA 的非侵入性技术。我们的主要目的是在重症监护病房（ICU）人群中研究先前发表的“仅 NIRS”CA 方法的临床可行性，并确定其与临床结果的关系。对双侧 NIRS 进行了 1-2 小时的测量。使用十分钟的数据段来计算高频氧合血红蛋白（oxyHb）和脱氧血红蛋白（deoxyHb）信号之间的传递函数分析（TFA）CA 估计。相位偏移已针对串行时间偏移进行了校正。定义了标准来选择具有“高通滤波器”特性的 TFA 相位图段（段）。在 54 名患者中，490 个 729 个段中的 490 个被自动选择（67%）。在 34 名原发性神经病患者中，19 名幸存者的低频（LF）相位偏移中位数（q1-q3）高于 15 名非幸存者（13°（6.3-35）比 0.83°（-2.8-13），= 0.0167）。使用段选择进行更稳健和一致的 CA 估计，使用仅 NIRS 方法似乎可以在 ICU 人群中进行 CA 估计。“仅 NIRS”方法需要进一步验证，但具有非侵入性的优点，无需动脉血压监测。
