Cerebral Autoregulation Assessment Using the Near Infrared Spectroscopy ‘NIRS-Only’ High Frequency Methodology in Critically Ill Patients: A Prospective Cross-Sectional Study
Jeanette Tas,
Nick Eleveld,
Melisa Borg,
Kirsten D. J. Bos,
Anne P. Langermans,
Sander M. J. van Kuijk,
Iwan C. C. van der Horst,
Jan Willem J. Elting,
Marcel J. H. Aries
Affiliations
Jeanette Tas
Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands
Nick Eleveld
Department of Neurology and Clinical Neurophysiology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
Melisa Borg
Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands
Kirsten D. J. Bos
Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands
Anne P. Langermans
Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands
Sander M. J. van Kuijk
Department of Clinical Epidemiology and Medical Technology Assessment, (KEMTA), Maastricht University Medical Center+, 6229 HX Maastricht, The Netherlands
Iwan C. C. van der Horst
Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands
Jan Willem J. Elting
Department of Neurology and Clinical Neurophysiology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
Marcel J. H. Aries
Department of Intensive Care Medicine, Maastricht University Medical Center+, University Maastricht, 6229 HX Maastricht, The Netherlands
Impairments in cerebral autoregulation (CA) are related to poor clinical outcome. Near infrared spectroscopy (NIRS) is a non-invasive technique applied to estimate CA. Our general purpose was to study the clinical feasibility of a previously published ‘NIRS-only’ CA methodology in a critically ill intensive care unit (ICU) population and determine its relationship with clinical outcome. Bilateral NIRS measurements were performed for 1–2 h. Data segments of ten-minutes were used to calculate transfer function analyses (TFA) CA estimates between high frequency oxyhemoglobin (oxyHb) and deoxyhemoglobin (deoxyHb) signals. The phase shift was corrected for serial time shifts. Criteria were defined to select TFA phase plot segments (segments) with ‘high-pass filter’ characteristics. In 54 patients, 490 out of 729 segments were automatically selected (67%). In 34 primary neurology patients the median (q1–q3) low frequency (LF) phase shift was higher in 19 survivors compared to 15 non-survivors (13° (6.3–35) versus 0.83° (−2.8–13), p = 0.0167). CA estimation using the NIRS-only methodology seems feasible in an ICU population using segment selection for more robust and consistent CA estimations. The ‘NIRS-only’ methodology needs further validation, but has the advantage of being non-invasive without the need for arterial blood pressure monitoring.
