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The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients
Introduction: The role of near-infrared spectroscopy (NIRS) for the evaluation of cerebral haemodynamics is gaining increasing popularity because of its noninvasive nature. The aim of this study was to evaluate the role of the integral components of regional cerebral oxygenation (rSO(2)) measured by...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722102/ https://www.ncbi.nlm.nih.gov/pubmed/34987461 http://dx.doi.org/10.3389/fneur.2021.735469 |
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author | Robba, Chiara Cardim, Danilo Ball, Lorenzo Battaglini, Denise Dabrowski, Wojciech Bassetti, Matteo Giacobbe, Daniele Roberto Czosnyka, Marek Badenes, Rafael Pelosi, Paolo Matta, Basil |
author_facet | Robba, Chiara Cardim, Danilo Ball, Lorenzo Battaglini, Denise Dabrowski, Wojciech Bassetti, Matteo Giacobbe, Daniele Roberto Czosnyka, Marek Badenes, Rafael Pelosi, Paolo Matta, Basil |
author_sort | Robba, Chiara |
collection | PubMed |
description | Introduction: The role of near-infrared spectroscopy (NIRS) for the evaluation of cerebral haemodynamics is gaining increasing popularity because of its noninvasive nature. The aim of this study was to evaluate the role of the integral components of regional cerebral oxygenation (rSO(2)) measured by NIRS [i.e., arterial-oxyhemoglobin (O(2)Hbi) and venous-deoxyhemoglobin (HHbi)-components], as indirect surrogates of cerebral blood flow (CBF) in a cohort of critically ill patients with coronavirus disease 2019 (COVID-19). We compared these findings to the gold standard technique for noninvasive CBF assessment, Transcranial Doppler (TCD). Methods: Mechanically ventilated patients with COVID-19 admitted to the Intensive Care Unit (ICU) of Policlinico San Martino Hospital, Genova, Italy, who underwent multimodal neuromonitoring (including NIRS and TCD), were included. rSO(2) and its components [relative changes in O(2)Hbi, HHbi, and total haemoglobin (cHbi)] were compared with TCD (cerebral blood flow velocity, CBFV). Changes (Δ) in CBFV and rSO(2), ΔO(2)Hbi, ΔHHbi, and ΔcHbi after systemic arterial blood pressure (MAP) modifications induced by different manoeuvres (e.g., rescue therapies and haemodynamic manipulation) were assessed using mixed-effect linear regression analysis and repeated measures correlation coefficients. All values were normalised as percentage changes from the baseline (Δ%). Results: One hundred and four measurements from 25 patients were included. Significant effects of Δ%MAP on Δ%CBF were observed after rescue manoeuvres for CBFV, ΔcHbi, and ΔO(2)Hbi. The highest correlation was found between ΔCBFV and ΔΔO(2)Hbi (R = 0.88, p < 0.0001), and the poorest between ΔCBFV and ΔΔHHbi (R = 0.34, p = 0.002). Conclusions: ΔO(2)Hbi had the highest accuracy to assess CBF changes, reflecting its role as the main component for vasomotor response after changes in MAP. The use of indexes derived from the different components of rSO(2) can be useful for the bedside evaluation of cerebral haemodynamics in mechanically ventilated patients with COVID-19. |
format | Online Article Text |
id | pubmed-8722102 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87221022022-01-04 The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients Robba, Chiara Cardim, Danilo Ball, Lorenzo Battaglini, Denise Dabrowski, Wojciech Bassetti, Matteo Giacobbe, Daniele Roberto Czosnyka, Marek Badenes, Rafael Pelosi, Paolo Matta, Basil Front Neurol Neurology Introduction: The role of near-infrared spectroscopy (NIRS) for the evaluation of cerebral haemodynamics is gaining increasing popularity because of its noninvasive nature. The aim of this study was to evaluate the role of the integral components of regional cerebral oxygenation (rSO(2)) measured by NIRS [i.e., arterial-oxyhemoglobin (O(2)Hbi) and venous-deoxyhemoglobin (HHbi)-components], as indirect surrogates of cerebral blood flow (CBF) in a cohort of critically ill patients with coronavirus disease 2019 (COVID-19). We compared these findings to the gold standard technique for noninvasive CBF assessment, Transcranial Doppler (TCD). Methods: Mechanically ventilated patients with COVID-19 admitted to the Intensive Care Unit (ICU) of Policlinico San Martino Hospital, Genova, Italy, who underwent multimodal neuromonitoring (including NIRS and TCD), were included. rSO(2) and its components [relative changes in O(2)Hbi, HHbi, and total haemoglobin (cHbi)] were compared with TCD (cerebral blood flow velocity, CBFV). Changes (Δ) in CBFV and rSO(2), ΔO(2)Hbi, ΔHHbi, and ΔcHbi after systemic arterial blood pressure (MAP) modifications induced by different manoeuvres (e.g., rescue therapies and haemodynamic manipulation) were assessed using mixed-effect linear regression analysis and repeated measures correlation coefficients. All values were normalised as percentage changes from the baseline (Δ%). Results: One hundred and four measurements from 25 patients were included. Significant effects of Δ%MAP on Δ%CBF were observed after rescue manoeuvres for CBFV, ΔcHbi, and ΔO(2)Hbi. The highest correlation was found between ΔCBFV and ΔΔO(2)Hbi (R = 0.88, p < 0.0001), and the poorest between ΔCBFV and ΔΔHHbi (R = 0.34, p = 0.002). Conclusions: ΔO(2)Hbi had the highest accuracy to assess CBF changes, reflecting its role as the main component for vasomotor response after changes in MAP. The use of indexes derived from the different components of rSO(2) can be useful for the bedside evaluation of cerebral haemodynamics in mechanically ventilated patients with COVID-19. Frontiers Media S.A. 2021-12-20 /pmc/articles/PMC8722102/ /pubmed/34987461 http://dx.doi.org/10.3389/fneur.2021.735469 Text en Copyright © 2021 Robba, Cardim, Ball, Battaglini, Dabrowski, Bassetti, Giacobbe, Czosnyka, Badenes, Pelosi, Matta and the GeCovid group. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Robba, Chiara Cardim, Danilo Ball, Lorenzo Battaglini, Denise Dabrowski, Wojciech Bassetti, Matteo Giacobbe, Daniele Roberto Czosnyka, Marek Badenes, Rafael Pelosi, Paolo Matta, Basil The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients |
title | The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients |
title_full | The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients |
title_fullStr | The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients |
title_full_unstemmed | The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients |
title_short | The Use of Different Components of Brain Oxygenation for the Assessment of Cerebral Haemodynamics: A Prospective Observational Study on COVID-19 Patients |
title_sort | use of different components of brain oxygenation for the assessment of cerebral haemodynamics: a prospective observational study on covid-19 patients |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8722102/ https://www.ncbi.nlm.nih.gov/pubmed/34987461 http://dx.doi.org/10.3389/fneur.2021.735469 |
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