Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Robba, Chiara, Cardim, Danilo, Ball, Lorenzo, Battaglini, Denise, Dabrowski, Wojciech, Bassetti, Matteo, Giacobbe, Daniele Roberto, Czosnyka, Marek, Badenes, Rafael, Pelosi, Paolo, Matta, Basil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
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
_version_ 1784625461405417472
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
work_keys_str_mv AT robbachiara theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT cardimdanilo theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT balllorenzo theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT battaglinidenise theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT dabrowskiwojciech theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT bassettimatteo theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT giacobbedanieleroberto theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT czosnykamarek theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT badenesrafael theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT pelosipaolo theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT mattabasil theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT theuseofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT robbachiara useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT cardimdanilo useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT balllorenzo useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT battaglinidenise useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT dabrowskiwojciech useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT bassettimatteo useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT giacobbedanieleroberto useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT czosnykamarek useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT badenesrafael useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT pelosipaolo useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT mattabasil useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients
AT useofdifferentcomponentsofbrainoxygenationfortheassessmentofcerebralhaemodynamicsaprospectiveobservationalstudyoncovid19patients