Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/86405
Type: Artigo de periódico
Title: Continuous Optical Monitoring Of Cerebral Hemodynamics During Head-of-bed Manipulation In Brain-injured Adults
Author: Kim M.N.
Edlow B.L.
Durduran T.
Frangos S.
Mesquita R.C.
Levine J.M.
Greenberg J.H.
Yodh A.G.
Detre J.A.
Abstract: Introduction: Head-of-bed manipulation is commonly performed in the neurocritical care unit to optimize cerebral blood flow (CBF), but its effects on CBF are rarely measured. This pilot study employs a novel, non-invasive instrument combining two techniques, diffuse correlation spectroscopy (DCS) for measurement of CBF and near-infrared spectroscopy (NIRS) for measurement of cerebral oxy- and deoxy-hemoglobin concentrations, to monitor patients during head-of-bed lowering. Methods: Ten brain-injured patients and ten control subjects were monitored continuously with DCS and NIRS while the head-of-bed was positioned first at 30° and then at 0°. Relative CBF (rCBF) and concurrent changes in oxy- (ΔHbO2), deoxy- (ΔHb), and total-hemoglobin concentrations (ΔTHC) from left/right frontal cortices were monitored for 5 min at each position. Patient and control response differences were assessed. Results: rCBF, ΔHbO2, and ΔTHC responses to head lowering differed significantly between brain-injured patients and healthy controls (P < 0.02). For patients, rCBF changes were heterogeneous, with no net change observed in the group average (0.3 ± 28.2 %, P = 0.938). rCBF increased in controls (18.6 ± 9.4 %, P < 0.001). ΔHbO2, ΔHb, and ΔTHC increased with head lowering in both groups, but to a larger degree in brain-injured patients. rCBF correlated moderately with changes in cerebral perfusion pressure (R = 0.40, P < 0.001), but not intracranial pressure. Conclusion: DCS/NIRS detected differences in CBF and oxygenation responses of brain-injured patients versus controls during head-of-bed manipulation. This pilot study supports the feasibility of continuous bedside measurement of cerebrovascular hemodynamics with DCS/NIRS and provides the rationale for further investigation in larger cohorts. © 2013 Springer Science+Business Media.
Editor: Humana Press Inc.
Rights: fechado
Identifier DOI: 10.1007/s12028-013-9849-7
Address: http://www.scopus.com/inward/record.url?eid=2-s2.0-84902330355&partnerID=40&md5=dbe737bed8a5d0852cc53b7c86d8abbd
Date Issue: 2014
Appears in Collections:Unicamp - Artigos e Outros Documentos

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