• An N Massaro, R B Govindan, Gilbert Vezina, Taeun Chang, Nickie N Andescavage, Yunfei Wang, Tareq Al-Shargabi, Marina Metzler, Kari Harris, and Adre J du Plessis.
• Division of Neonatology, Children's National Health System, Washington, District of Columbia; Division of Fetal and Transitional Medicine, Children's National Health System, Washington, District of Columbia; Department of Pediatrics, The George Washington University School of Medicine, Washington, District of Columbia anguyenm@childrensnational.org.
• J. Neurophysiol. 2015 Aug 1; 114 (2): 818-24.

AbstractImpaired cerebral autoregulation may contribute to secondary injury in newborns with hypoxic-ischemic encephalopathy (HIE). Continuous, noninvasive assessment of cerebral pressure autoregulation can be achieved with bedside near-infrared spectroscopy (NIRS) and systemic mean arterial blood pressure (MAP) monitoring. This study aimed to evaluate whether impaired cerebral autoregulation measured by NIRS-MAP monitoring during therapeutic hypothermia and rewarming relates to outcome in 36 newborns with HIE. Spectral coherence analysis between NIRS and MAP was used to quantify changes in the duration [pressure passivity index (PPI)] and magnitude (gain) of cerebral autoregulatory impairment. Higher PPI in both cerebral hemispheres and gain in the right hemisphere were associated with neonatal adverse outcomes [death or detectable brain injury by magnetic resonance imaging (MRI), P < 0.001]. NIRS-MAP monitoring of cerebral autoregulation can provide an ongoing physiological biomarker that may help direct care in perinatal brain injury.Copyright © 2015 the American Physiological Society.

25 keywords...

hide…