Low frequency power in cerebral blood flow is a biomarker of neurologic injury in the acute period after cardiac arrest.
Low frequency power in cerebral blood flow is a biomarker of neurologic injury in the acute period after cardiac arrest.
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DOI：
10.1016/j.resuscitation.2022.07.004
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发表时间：
2022-09
期刊：
影响因子：
6.5
通讯作者：
Kilbaugh, Todd J.
中科院分区：
文献类型：
--
作者：
White, Brian R.;Ko, Tiffany S.;Morgan, Ryan W.;Baker, Wesley B.;Benson, Emilie J.;Lafontant, Alec;Starr, Jonathan P.;Landis, William P.;Andersen, Kristen;Jahnavi, Jharna;Breimann, Jake;Delso, Nile;Morton, Sarah;Roberts, Anna L.;Lin, Yuxi;Graham, Kathryn;Berg, Robert A.;Yodh, Arjun G.;Licht, Daniel J.;Kilbaugh, Todd J.
关键词：
心脏骤停常导致严重的神经系统损伤。改善对这些患者的护理是困难的，因为很少有非侵入性生物标志物允许医生监测神经健康。脑血流动力学中的低频功率（LFP，0.01-0.1 Hz）的量已在功能磁共振成像中用作神经元活动的标记。我们的假设是，脑血流量（CBF）中LFP的增加与神经系统健康的侵入性措施的改善相关。我们采用了LFP来监测脑血流的扩散相关光谱。我们询问LFP（或其他光学生物标志物）是否与小儿心脏骤停猪模型（野猪，8-11 kg，51%雌性）恢复自主循环后4小时内神经元损伤的侵入性微透析生物标志物（乳酸-丙酮酸比- LPR -和甘油浓度）相关。使用混合线性效应模型检验关联性。我们发现，较高的LFP与较高的LPR和较高的甘油浓度相关。没有其他生物标志物与LPR相关;脑血红蛋白浓度、氧提取分数和一种EEG指标与甘油浓度相关。与预期相反，CBF中较高的LFP与较差的侵袭性生物标志物相关。较高的LFP可能代表较高的神经活动，或神经血管耦合的中断。在心脏骤停后的急性期，任何一种效应都可能是有害的。因此，这些结果表明，我们的方法有望开发新的临床相关生物标志物，而不是指导复苏和复苏后护理。19-001327
Cardiac arrest often results in severe neurologic injury. Improving care for these patients is difficult as few noninvasive biomarkers exist that allow physicians to monitor neurologic health. The amount of low-frequency power (LFP, 0.01–0.1 Hz) in cerebral haemodynamics has been used in functional magnetic resonance imaging as a marker of neuronal activity. Our hypothesis was that increased LFP in cerebral blood flow (CBF) would be correlated with improvements in invasive measures of neurologic health. We adapted the use of LFP for to monitoring of CBF with diffuse correlation spectroscopy. We asked whether LFP (or other optical biomarkers) correlated with invasive microdialysis biomarkers (lactate-pyruvate ratio – LPR – and glycerol concentration) of neuronal injury in the 4 hours after return of spontaneous circulation in a swine model of paediatric cardiac arrest (Sus scrofa domestica, 8–11 kg, 51% female). Associations were tested using a mixed linear effects model. We found that higher LFP was associated with higher LPR and higher glycerol concentration. No other biomarkers were associated with LPR; cerebral haemoglobin concentration, oxygen extraction fraction, and one EEG metric were associated with glycerol concentration. Contrary to expectations, higher LFP in CBF was correlated with worse invasive biomarkers. Higher LFP may represent higher neurologic activity, or disruptions in neurovascular coupling. Either effect may be harmful in the acute period after cardiac arrest. Thus, these results suggest our methodology holds promise for development of new, clinically relevant biomarkers than can guide resuscitation and post-resuscitation care. 19-001327
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影响因子：
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