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Journal of Clinical Monitoring and Computing

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17-05-2023 | Hypoxic-Ischemic Brain Injury | Letter to the Editor

Are NIRS-derived cerebral autoregulation and ABPopt values different between hemispheres in hypoxic-ischemic brain injury patients following cardiac arrest?

Authors: L Hazenberg, MJH Aries, E Beqiri, WH Mess, WNKA van Mook, T Delnoij, FA Zeiler, SMJ van Kuijk, J Tas

Published in: Journal of Clinical Monitoring and Computing | Issue 5/2023

Abstract

Purpose

Near-infrared spectroscopy (NIRS) has been suggested as a non-invasive monitoring technique to set cerebral autoregulation (CA) guided ABP targets (ABPopt) in comatose patients with hypoxic-ischemic brain injury (HIBI) following cardiac arrest. We aimed to determine whether NIRS-derived CA and ABPopt values differ between left and right-sided recordings in these patients.

Methods

Bifrontal regional oxygen saturation (rSO₂) was measured using INVOS or Fore-Sight devices. The Cerebral Oximetry index (COx) was determined as a CA measure. ABPopt was calculated using a published algorithm with multi-window weighted approach. A paired Wilcoxon signed rank test and intraclass correlation coefficients (ICC) were used to compare (1) systematic differences and (2) degree of agreement between left and right-sided measurements.

Results

Eleven patients were monitored. In one patient there was malfunctioning of the right-sided optode and in one patient not any ABPopt value was calculated. Comparison of rSO₂ and COx was possible in ten patients and ABPopt in nine patients. The average recording time was 26 (IQR, 22–42) hours. The ABPopt values were not significantly different between the bifrontal recordings (80 (95%-CI 76-84) and 82 (95%-CI 75-84) mmHg) for the left and right recordings, p = 1.0). The ICC for ABPopt was high (0.95, 0.78–0.98, p < 0.001). Similar results were obtained for rSO₂ and COx.

Conclusion

We found no differences between left and right-sided NIRS recordings or CA estimation in comatose and ventilated HIBI patients. This suggests that in these patients without signs of localized pathology unilateral recordings might be sufficient to estimate CA status or provide ABPopt targets.

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Title: Are NIRS-derived cerebral autoregulation and ABPopt values different between hemispheres in hypoxic-ischemic brain injury patients following cardiac arrest?
Authors: L Hazenberg
MJH Aries
E Beqiri
WH Mess
WNKA van Mook
T Delnoij
FA Zeiler
SMJ van Kuijk
J Tas
Publication date: 17-05-2023
Publisher: Springer Netherlands
Keyword: Hypoxic-Ischemic Brain Injury
Published in: Journal of Clinical Monitoring and Computing / Issue 5/2023
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-023-01008-2

At a glance: The STEP trials

Springer Medicine

Are NIRS-derived cerebral autoregulation and ABPopt values different between hemispheres in hypoxic-ischemic brain injury patients following cardiac arrest?

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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