The ontogeny of cerebrovascular pressure autoregulation in premature infants

Christopher J. Rhee, Charles D. Fraser, Kathleen Kibler, Ronald B. Easley, Dean B. Andropoulos, Marek Czosnyka, Georgios V. Varsos, Peter Smielewski, Craig G. Rusin, Ken M. Brady, Jeffrey R. Kaiser

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Our objective was to quantify cerebrovascular autoregulation as a function of gestational age (GA) and across the phases of the cardiac cycle. One hundred eightysix premature infants, with a GA range of 23-33 weeks, were monitored using umbilical artery catheters and transcranial Doppler insonation of middle cerebral artery flow velocity (FV) for 1-h sessions over the first week of life. Autoregulation was quantified as a moving correlation coefficient between systolic arterial blood pressure (ABP) and systolic FV (Sx); mean ABP and mean FV (Mx); diastolic ABP and diastolic FV (Dx). Autoregulation was compared across GAs for each aspect of the cardiac cycle. Systolic FV was pressure-passive in infants with the lowest GA, and Sx decreased with increased GA (r = -0.3; p < 0.001). By contrast, Dx was elevated in all subjects, and showed minimal change with increased GA (r = -0.06; p = 0.05). Multivariate analysis confirmed that GA (p < 0.001) and the "closing margin" (p < 0.01) were associated with Sx. Premature infants have low and almost always pressure-passive diastolic cerebral blood FV. Conversely, the regulation of systolic cerebral blood FV by autoregulation was manifested in this cohort at a GA of between 23 and 33 weeks.

Original languageEnglish (US)
Pages (from-to)151-155
Number of pages5
JournalActa Neurochirurgica, Supplementum
Volume122
DOIs
StatePublished - Jan 1 2016

Fingerprint

Premature Infants
Gestational Age
Homeostasis
Pressure
Cerebrovascular Circulation
Arterial Pressure
Blood Flow Velocity
Umbilical Arteries
Middle Cerebral Artery
Multivariate Analysis
Catheters
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Rhee, Christopher J. ; Fraser, Charles D. ; Kibler, Kathleen ; Easley, Ronald B. ; Andropoulos, Dean B. ; Czosnyka, Marek ; Varsos, Georgios V. ; Smielewski, Peter ; Rusin, Craig G. ; Brady, Ken M. ; Kaiser, Jeffrey R. / The ontogeny of cerebrovascular pressure autoregulation in premature infants. In: Acta Neurochirurgica, Supplementum. 2016 ; Vol. 122. pp. 151-155.
@article{ff01810fbfb24203afa527fd7187ac44,
title = "The ontogeny of cerebrovascular pressure autoregulation in premature infants",
abstract = "Our objective was to quantify cerebrovascular autoregulation as a function of gestational age (GA) and across the phases of the cardiac cycle. One hundred eightysix premature infants, with a GA range of 23-33 weeks, were monitored using umbilical artery catheters and transcranial Doppler insonation of middle cerebral artery flow velocity (FV) for 1-h sessions over the first week of life. Autoregulation was quantified as a moving correlation coefficient between systolic arterial blood pressure (ABP) and systolic FV (Sx); mean ABP and mean FV (Mx); diastolic ABP and diastolic FV (Dx). Autoregulation was compared across GAs for each aspect of the cardiac cycle. Systolic FV was pressure-passive in infants with the lowest GA, and Sx decreased with increased GA (r = -0.3; p < 0.001). By contrast, Dx was elevated in all subjects, and showed minimal change with increased GA (r = -0.06; p = 0.05). Multivariate analysis confirmed that GA (p < 0.001) and the {"}closing margin{"} (p < 0.01) were associated with Sx. Premature infants have low and almost always pressure-passive diastolic cerebral blood FV. Conversely, the regulation of systolic cerebral blood FV by autoregulation was manifested in this cohort at a GA of between 23 and 33 weeks.",
author = "Rhee, {Christopher J.} and Fraser, {Charles D.} and Kathleen Kibler and Easley, {Ronald B.} and Andropoulos, {Dean B.} and Marek Czosnyka and Varsos, {Georgios V.} and Peter Smielewski and Rusin, {Craig G.} and Brady, {Ken M.} and Kaiser, {Jeffrey R.}",
year = "2016",
month = "1",
day = "1",
doi = "10.1007/978-3-319-22533-3_31",
language = "English (US)",
volume = "122",
pages = "151--155",
journal = "Acta Neurochirurgica, Supplement",
issn = "0065-1419",
publisher = "Springer Wien",

}

Rhee, CJ, Fraser, CD, Kibler, K, Easley, RB, Andropoulos, DB, Czosnyka, M, Varsos, GV, Smielewski, P, Rusin, CG, Brady, KM & Kaiser, JR 2016, 'The ontogeny of cerebrovascular pressure autoregulation in premature infants', Acta Neurochirurgica, Supplementum, vol. 122, pp. 151-155. https://doi.org/10.1007/978-3-319-22533-3_31

The ontogeny of cerebrovascular pressure autoregulation in premature infants. / Rhee, Christopher J.; Fraser, Charles D.; Kibler, Kathleen; Easley, Ronald B.; Andropoulos, Dean B.; Czosnyka, Marek; Varsos, Georgios V.; Smielewski, Peter; Rusin, Craig G.; Brady, Ken M.; Kaiser, Jeffrey R.

In: Acta Neurochirurgica, Supplementum, Vol. 122, 01.01.2016, p. 151-155.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The ontogeny of cerebrovascular pressure autoregulation in premature infants

AU - Rhee, Christopher J.

AU - Fraser, Charles D.

AU - Kibler, Kathleen

AU - Easley, Ronald B.

AU - Andropoulos, Dean B.

AU - Czosnyka, Marek

AU - Varsos, Georgios V.

AU - Smielewski, Peter

AU - Rusin, Craig G.

AU - Brady, Ken M.

AU - Kaiser, Jeffrey R.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Our objective was to quantify cerebrovascular autoregulation as a function of gestational age (GA) and across the phases of the cardiac cycle. One hundred eightysix premature infants, with a GA range of 23-33 weeks, were monitored using umbilical artery catheters and transcranial Doppler insonation of middle cerebral artery flow velocity (FV) for 1-h sessions over the first week of life. Autoregulation was quantified as a moving correlation coefficient between systolic arterial blood pressure (ABP) and systolic FV (Sx); mean ABP and mean FV (Mx); diastolic ABP and diastolic FV (Dx). Autoregulation was compared across GAs for each aspect of the cardiac cycle. Systolic FV was pressure-passive in infants with the lowest GA, and Sx decreased with increased GA (r = -0.3; p < 0.001). By contrast, Dx was elevated in all subjects, and showed minimal change with increased GA (r = -0.06; p = 0.05). Multivariate analysis confirmed that GA (p < 0.001) and the "closing margin" (p < 0.01) were associated with Sx. Premature infants have low and almost always pressure-passive diastolic cerebral blood FV. Conversely, the regulation of systolic cerebral blood FV by autoregulation was manifested in this cohort at a GA of between 23 and 33 weeks.

AB - Our objective was to quantify cerebrovascular autoregulation as a function of gestational age (GA) and across the phases of the cardiac cycle. One hundred eightysix premature infants, with a GA range of 23-33 weeks, were monitored using umbilical artery catheters and transcranial Doppler insonation of middle cerebral artery flow velocity (FV) for 1-h sessions over the first week of life. Autoregulation was quantified as a moving correlation coefficient between systolic arterial blood pressure (ABP) and systolic FV (Sx); mean ABP and mean FV (Mx); diastolic ABP and diastolic FV (Dx). Autoregulation was compared across GAs for each aspect of the cardiac cycle. Systolic FV was pressure-passive in infants with the lowest GA, and Sx decreased with increased GA (r = -0.3; p < 0.001). By contrast, Dx was elevated in all subjects, and showed minimal change with increased GA (r = -0.06; p = 0.05). Multivariate analysis confirmed that GA (p < 0.001) and the "closing margin" (p < 0.01) were associated with Sx. Premature infants have low and almost always pressure-passive diastolic cerebral blood FV. Conversely, the regulation of systolic cerebral blood FV by autoregulation was manifested in this cohort at a GA of between 23 and 33 weeks.

UR - http://www.scopus.com/inward/record.url?scp=84969931849&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84969931849&partnerID=8YFLogxK

U2 - 10.1007/978-3-319-22533-3_31

DO - 10.1007/978-3-319-22533-3_31

M3 - Article

C2 - 27165897

AN - SCOPUS:84969931849

VL - 122

SP - 151

EP - 155

JO - Acta Neurochirurgica, Supplement

JF - Acta Neurochirurgica, Supplement

SN - 0065-1419

ER -

Rhee CJ, Fraser CD, Kibler K, Easley RB, Andropoulos DB, Czosnyka M et al. The ontogeny of cerebrovascular pressure autoregulation in premature infants. Acta Neurochirurgica, Supplementum. 2016 Jan 1;122:151-155. https://doi.org/10.1007/978-3-319-22533-3_31