Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?
Assessment of dynamic cerebral autoregulation in humans: Is reproducibility dependent on blood pressure variability?
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DOI：
10.1371/journal.pone.0227651
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发表时间：
2020-01-10
期刊：
影响因子：
3.7
通讯作者：
Claassen, Jurgen A. H. R.
中科院分区：
文献类型：
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作者：
Elting, Jan Willem;Sanders, Marit L.;Claassen, Jurgen A. H. R.
我们测试了血压变异性对动态脑自动调节（DCA）估计的再现性的影响。对第二次 CARNet Bootstrap 计划的数据进行了分析，其中对 75 名健康受试者进行了两次平均动脉血压 (MABP)、脑血流速度 (CBFV) 和潮气末 CO2 测量。 DCA 由 14 个不同的中心采用多种不同的分析方法进行分析。当从所有增益、相位和自动调节指数 (ARI) 参数的分析中删除具有低功率谱密度 MABP (PSD-MABP) 值的受试者时，组内相关性 (ICC) 值显着增加。低频段 (LF) 增益的 ICC 最高，其次是相位 LF 和极低频段增益。对于增益参数的分析方法之间没有发现显着差异，但是对于相位和ARI参数，分析方法之间发现了显着差异。或者，Spearman-Brown 预测公式表明，可能需要将测量持续时间延长至 35 分钟，才能实现某些 DCA 参数的良好再现性。我们得出的结论是，当去除 PSD-MABP 较低的病例时，或者当测量持续时间增加时，较差的 DCA 再现性 (ICC< 0.4) 可以改善为良好的 (ICC > 0.6) 值。
We tested the influence of blood pressure variability on the reproducibility of dynamic cerebral autoregulation (DCA) estimates. Data were analyzed from the 2nd CARNet bootstrap initiative, where mean arterial blood pressure (MABP), cerebral blood flow velocity (CBFV) and end tidal CO2 were measured twice in 75 healthy subjects. DCA was analyzed by 14 different centers with a variety of different analysis methods. Intraclass Correlation (ICC) values increased significantly when subjects with low power spectral density MABP (PSD-MABP) values were removed from the analysis for all gain, phase and autoregulation index (ARI) parameters. Gain in the low frequency band (LF) had the highest ICC, followed by phase LF and gain in the very low frequency band. No significant differences were found between analysis methods for gain parameters, but for phase and ARI parameters, significant differences between the analysis methods were found. Alternatively, the Spearman-Brown prediction formula indicated that prolongation of the measurement duration up to 35 minutes may be needed to achieve good reproducibility for some DCA parameters. We conclude that poor DCA reproducibility (ICC< 0.4) can improve to good (ICC > 0.6) values when cases with low PSD-MABP are removed, and probably also when measurement duration is increased.