The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study
<p>Abstract</p> <p>Background</p> <p>The insertion of Ventricular Assist Devices is a common strategy for cardiovascular support in patients with refractory cardiogenic shock. This study sought to determine the impact of ventricular assist devices on the dynamic relatio...
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| Format: | Article |
| Language: | English |
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BMC
2011-02-01
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| Series: | BMC Anesthesiology |
| Online Access: | http://www.biomedcentral.com/1471-2253/11/4 |
| _version_ | 1818662573403275264 |
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| author | Dunster Kimble R Barnett Adrian G Ainslie Philip Tzeng Yu-Chieh Chan Gregory S Bellapart Judith Boots Rob Fraser John F |
| author_facet | Dunster Kimble R Barnett Adrian G Ainslie Philip Tzeng Yu-Chieh Chan Gregory S Bellapart Judith Boots Rob Fraser John F |
| author_sort | Dunster Kimble R |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The insertion of Ventricular Assist Devices is a common strategy for cardiovascular support in patients with refractory cardiogenic shock. This study sought to determine the impact of ventricular assist devices on the dynamic relationship between arterial blood pressure and cerebral blood flow velocity.</p> <p>Methods</p> <p>A sample of 5 patients supported with a pulsatile ventricular assist device was compared with 5 control patients. Controls were matched for age, co-morbidities, current diagnosis and cardiac output state, to cases. Beat-to-beat recordings of mean arterial pressure and cerebral blood flow velocity, using transcranial Doppler were obtained. Transfer function analysis was performed on the lowpass filtered pressure and flow signals, to assess gain, phase and coherence of the relationship between mean arterial blood pressure and cerebral blood flow velocity. These parameters were derived from the very low frequency (0.02-0.07 Hz), low frequency (0.07-0.2 Hz) and high frequency (0.2-0.35 Hz).</p> <p>Results</p> <p>No significant difference was found in gain and phase values between the two groups, but the low frequency coherence was significantly higher in cases compared with controls (mean ± SD: 0.65 ± 0.16 vs 0.38 ± 0.19, <it>P </it>= 0.04). The two cases with highest coherence (~0.8) also had much higher spectral power in mean arterial blood pressure.</p> <p>Conclusions</p> <p>Pulsatile ventricular assist devices affect the coherence but not the gain or phase of the cerebral pressure-flow relationship in the low frequency range; thus whether there was any significant disruption of cerebral autoregulation mechanism was not exactly clear. The augmentation of input pressure fluctuations might contribute in part to the higher coherence observed.</p> |
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| format | Article |
| id | doaj.art-7d73e8fd86b246e1a1b18a1631150b81 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-17T05:03:06Z |
| publishDate | 2011-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-7d73e8fd86b246e1a1b18a1631150b812022-12-21T22:02:31ZengBMCBMC Anesthesiology1471-22532011-02-01111410.1186/1471-2253-11-4The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary studyDunster Kimble RBarnett Adrian GAinslie PhilipTzeng Yu-ChiehChan Gregory SBellapart JudithBoots RobFraser John F<p>Abstract</p> <p>Background</p> <p>The insertion of Ventricular Assist Devices is a common strategy for cardiovascular support in patients with refractory cardiogenic shock. This study sought to determine the impact of ventricular assist devices on the dynamic relationship between arterial blood pressure and cerebral blood flow velocity.</p> <p>Methods</p> <p>A sample of 5 patients supported with a pulsatile ventricular assist device was compared with 5 control patients. Controls were matched for age, co-morbidities, current diagnosis and cardiac output state, to cases. Beat-to-beat recordings of mean arterial pressure and cerebral blood flow velocity, using transcranial Doppler were obtained. Transfer function analysis was performed on the lowpass filtered pressure and flow signals, to assess gain, phase and coherence of the relationship between mean arterial blood pressure and cerebral blood flow velocity. These parameters were derived from the very low frequency (0.02-0.07 Hz), low frequency (0.07-0.2 Hz) and high frequency (0.2-0.35 Hz).</p> <p>Results</p> <p>No significant difference was found in gain and phase values between the two groups, but the low frequency coherence was significantly higher in cases compared with controls (mean ± SD: 0.65 ± 0.16 vs 0.38 ± 0.19, <it>P </it>= 0.04). The two cases with highest coherence (~0.8) also had much higher spectral power in mean arterial blood pressure.</p> <p>Conclusions</p> <p>Pulsatile ventricular assist devices affect the coherence but not the gain or phase of the cerebral pressure-flow relationship in the low frequency range; thus whether there was any significant disruption of cerebral autoregulation mechanism was not exactly clear. The augmentation of input pressure fluctuations might contribute in part to the higher coherence observed.</p>http://www.biomedcentral.com/1471-2253/11/4 |
| spellingShingle | Dunster Kimble R Barnett Adrian G Ainslie Philip Tzeng Yu-Chieh Chan Gregory S Bellapart Judith Boots Rob Fraser John F The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study BMC Anesthesiology |
| title | The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study |
| title_full | The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study |
| title_fullStr | The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study |
| title_full_unstemmed | The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study |
| title_short | The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study |
| title_sort | effect of ventricular assist devices on cerebral autoregulation a preliminary study |
| url | http://www.biomedcentral.com/1471-2253/11/4 |
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