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Random perturbations of arterial blood pressure for the assessment of dynamic cerebral autoregulation

Random perturbations of arterial blood pressure for the assessment of dynamic cerebral autoregulation
Random perturbations of arterial blood pressure for the assessment of dynamic cerebral autoregulation
The assessment of cerebral autoregulation (CA) relies mostly on methods that modulate arterial blood pressure (ABP). Despite advances, the gold standard of assessment remains elusive and clinical practicality is limited. We investigate a novel approach of assessing CA, consisting of the intermittent application of thigh cuffs using square wave sequences. Our aim was to increase ABP variability whilst minimizing volunteer discomfort, thus improving assessment acceptability. Two random square wave sequences and two maximum pressure settings (80 and 150 mmHg) were used, corresponding to four manoeuvres that were conducted in random order after a baseline recording. The intermittent application of thigh cuffs resulted in an amplitude dependent increase in ABP (p = 0.001) and cerebral blood flow velocity (CBFV) variability (p = 0.026) compared to baseline. No statistically significant differences in mean heart rate or heart rate variability were observed (p = 0.108 and p = 0.350, respectively), suggesting that no significant sympathetic response was elicited. No significant differences in the CBFV step response were observed, suggesting no distortion of autoregulatory parameters resulted from the use of thigh cuffs. We conclude that pseudorandom binary sequences are an effective and safe alternative for increasing ABP variability. This new approach shows great promise as a tool for the robust assessment of CA.


cerebral autoregulation, cerebral blood flow, arterial blood pressure, pseudorandom binary sequences
0967-3334
103-116
Katsogridakis, Emmanuel
863d80d0-d656-453d-98fe-70f2c16aaaf9
Bush, Glen
cfea4e31-c324-480d-8308-72356a501af1
Fan, Lingke
f5684ccc-f5ef-4613-89bb-1b61ec6f74b6
Birch, Anthony A.
755f2236-4c0c-49b5-9884-de4021acd42d
Simpson, David M.
53674880-f381-4cc9-8505-6a97eeac3c2a
Allen, Robert
956a918f-278c-48ef-8e19-65aa463f199a
Potter, John F.
b49c726b-7954-429e-bc1c-37639a39e428
Panerai, Ronney B.
7acaf714-a17c-4df2-a1f3-b148c1445517
Katsogridakis, Emmanuel
863d80d0-d656-453d-98fe-70f2c16aaaf9
Bush, Glen
cfea4e31-c324-480d-8308-72356a501af1
Fan, Lingke
f5684ccc-f5ef-4613-89bb-1b61ec6f74b6
Birch, Anthony A.
755f2236-4c0c-49b5-9884-de4021acd42d
Simpson, David M.
53674880-f381-4cc9-8505-6a97eeac3c2a
Allen, Robert
956a918f-278c-48ef-8e19-65aa463f199a
Potter, John F.
b49c726b-7954-429e-bc1c-37639a39e428
Panerai, Ronney B.
7acaf714-a17c-4df2-a1f3-b148c1445517

Katsogridakis, Emmanuel, Bush, Glen and Fan, Lingke et al. (2012) Random perturbations of arterial blood pressure for the assessment of dynamic cerebral autoregulation. Physiological Measurement, 33 (2), 103-116. (doi:10.1088/0967-3334/33/2/103). (PMID:22227772)

Record type: Article

Abstract

The assessment of cerebral autoregulation (CA) relies mostly on methods that modulate arterial blood pressure (ABP). Despite advances, the gold standard of assessment remains elusive and clinical practicality is limited. We investigate a novel approach of assessing CA, consisting of the intermittent application of thigh cuffs using square wave sequences. Our aim was to increase ABP variability whilst minimizing volunteer discomfort, thus improving assessment acceptability. Two random square wave sequences and two maximum pressure settings (80 and 150 mmHg) were used, corresponding to four manoeuvres that were conducted in random order after a baseline recording. The intermittent application of thigh cuffs resulted in an amplitude dependent increase in ABP (p = 0.001) and cerebral blood flow velocity (CBFV) variability (p = 0.026) compared to baseline. No statistically significant differences in mean heart rate or heart rate variability were observed (p = 0.108 and p = 0.350, respectively), suggesting that no significant sympathetic response was elicited. No significant differences in the CBFV step response were observed, suggesting no distortion of autoregulatory parameters resulted from the use of thigh cuffs. We conclude that pseudorandom binary sequences are an effective and safe alternative for increasing ABP variability. This new approach shows great promise as a tool for the robust assessment of CA.


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More information

e-pub ahead of print date: 6 January 2012
Keywords: cerebral autoregulation, cerebral blood flow, arterial blood pressure, pseudorandom binary sequences
Organisations: Faculty of Medicine, Signal Processing & Control Grp

Identifiers

Local EPrints ID: 208195
URI: http://eprints.soton.ac.uk/id/eprint/208195
ISSN: 0967-3334
PURE UUID: 7b4fc8d9-5c05-438e-9329-bdf9871b9e67
ORCID for Anthony A. Birch: ORCID iD orcid.org/0000-0002-2328-702X

Catalogue record

Date deposited: 17 Jan 2012 12:18
Last modified: 20 Jul 2019 00:23

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