TY - JOUR
T1 - Assessment of dynamic cerebral autoregulation in humans
T2 - Is reproducibility dependent on blood pressure variability?
AU - Elting, Jan Willem
AU - Sanders, Marit L.
AU - Panerai, Ronney B.
AU - Aries, Marcel
AU - Bor-Seng-Shu, Edson
AU - Caicedo, Alexander
AU - Chacon, Max
AU - Gommer, Erik D.
AU - Van Huffel, Sabine
AU - Jara, José L.
AU - Kostoglou, Kyriaki
AU - Mahdi, Adam
AU - Marmarelis, Vasilis Z.
AU - Mitsis, Georgios D.
AU - Müller, Martin
AU - Nikolic, Dragana
AU - Nogueira, Ricardo C.
AU - Payne, Stephen J.
AU - Puppo, Corina
AU - Shin, Dae C.
AU - Simpson, David M.
AU - Tarumi, Takashi
AU - Yelicich, Bernardo
AU - Zhang, Rong
AU - Claassen, Jurgen A.H.R.
PY - 2020/1/1
Y1 - 2020/1/1
N2 - 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.
AB - 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.
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U2 - 10.1371/journal.pone.0227651
DO - 10.1371/journal.pone.0227651
M3 - Article
C2 - 31923919
AN - SCOPUS:85077765738
SN - 1932-6203
VL - 15
SP - e0227651
JO - PLOS ONE
JF - PLOS ONE
IS - 1
M1 - e0227651
ER -