Regional cerebral oxygenation measured by multichannel near-infrared spectroscopy (optical topography) in an infant supported on venoarterial extracorporeal membrane oxygenation

Papademetriou, Maria D.; Tachtsidis, Ilias; Banaji, Murad; Elliott, Martin J.; Hoskote, Aparna; Elwell, Clare E.

doi:10.1016/j.jtcvs.2011.01.026

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…Previously we used a dual-channel NIRS system and showed the presence of oscillations related to vasomotion, respiration, and heart rates [ 7 ]. Preliminary results using multichannel NIRS indicate regional variation in cerebral oxygenation [ 8 ]. Here, we investigate the use of WCC as a method to study the concordance between multisite cerebral HbO 2 and mean arterial pressure in order to assess regional variations in cerebral oxygenation in neonates supported on ECMO.…”

Section: Introductionmentioning

confidence: 99%

Wavelet Cross-Correlation to Investigate Regional Variations in Cerebral Oxygenation in Infants Supported on Extracorporeal Membrane Oxygenation

Papademetriou

Tachtsidis

Elliott

et al. 2012

Advances in Experimental Medicine and Biology

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Extracorporeal membrane oxygenation can potentially affect cerebral blood flow dynamics and consequently influence cerebral autoregulation. We applied wavelet cross-correlation (WCC) between multichannel cerebral oxyhemoglobin concentration (HbO2) and mean arterial pressure (MAP), to assess regional variations in cerebral autoregulation. Six infants on veno-arterial (VA) ECMO were studied during sequential changes in the ECMO flows. WCC between MAP and HbO2 for each flow period and each channel was calculated within three different frequency (wavelet scale) bands centered around 0.1, 0.16, and 0.3 Hz chosen to represent low frequency oscillations, ventilation, and respiration rates, respectively. The group data showed a relationship between maximum WCC and ECMO flow. During changes in ECMO flow, statistically significant differences in maximum WCC were found between right and left hemispheres. WCC between HbO2 and MAP provides a useful method to investigate the dynamics of cerebral autoregulation during ECMO. Manipulations of ECMO flows are associated with regional changes in cerebral autoregulation which may potentially have an important bearing on clinical outcome.

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Section: Introductionmentioning

confidence: 99%

Wavelet Cross-Correlation to Investigate Regional Variations in Cerebral Oxygenation in Infants Supported on Extracorporeal Membrane Oxygenation

Papademetriou

Tachtsidis

Elliott

et al. 2012

Advances in Experimental Medicine and Biology

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“…118,119 In children, NIRS in a 12-channel device has been used to evaluate variations in cerebral oxygenation of vessel liga-tion. 108,110,120,121 It has been proposed that NIRS in conjunction with wavelet cross-correlation analysis may be used in a multimodal device to assess both regional variations in cerebral oxygenation and autoregulation in children treated with ECMO. 122…”

Section: Near-infrared Spectroscopymentioning

confidence: 99%

Brain Injury in Extracorporeal Membrane Oxygenation: A Multidisciplinary Approach

et al. 2021

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Extracorporeal membrane oxygenation (ECMO) represents an established technique to provide temporary cardiac and/or pulmonary support. ECMO, in veno-venous, veno-arterial or in extracorporeal carbon dioxide removal modality, is associated with a high rate of brain injuries. These complications have been reported in 7 to 15% of adults and 20% of neonates, and are associated with poor survival. Thromboembolic events, loss of cerebral autoregulation, alteration of the blood–brain barrier, and hemorrhage related to anticoagulation represent the main causes of severe brain injury during ECMO. The most frequent forms of acute neurological injuries in ECMO patients are intracranial hemorrhage (2–21%), ischemic stroke (2–10%), seizures (2–6%), and hypoxic–ischemic brain injury; brain death may also occur in this population. Other frequent complications are infarction (1–8%) and cerebral edema (2–10%), as well as neuropsychological and psychiatric sequelae, including posttraumatic stress disorder.

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“…Preliminary results using a multichannel NIRS system indicate regional variation in cerebral oxygenation responses during ECMO flow changes. 30 Here, we are investigating the use of WCC as a method to study the concordance between multisite cerebral oxyhaemoglobin concentration measures and MAP in order to assess regional variations in cerebral autoregulation in neonates supported on ECMO. The long term aim of our work is the continuous bedside, noninvasive, real time assessment of regional dynamic cerebral autoregulation that will potentially aid clinical management of infants and children supported on extracorporeal circulation.…”

Section: Introductionmentioning

confidence: 99%

Multichannel near infrared spectroscopy indicates regional variations in cerebral autoregulation in infants supported on extracorporeal membrane oxygenation

et al. 2012

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Abstract. Assessing noninvasively cerebral autoregulation, the protective mechanism of the brain to maintain constant cerebral blood flow despite changes in blood pressure, is challenging. Infants on life support system (ECMO) for cardiorespiratory failure are at risk of cerebral autoregulation impairment and consequent neurological problems. We measured oxyhaemoglobin concentration (HbO 2 ) by multichannel (12 channels) near-infrared spectroscopy (NIRS) in six infants during sequential changes in ECMO flow. Wavelet cross-correlation (WCC) between mean arterial pressure (MAP) and HbO 2 was used to construct a time-frequency representation of the concordance between the two signals to assess the nonstationary aspect of cerebral autoregulation and investigate regional variations. Group data showed that WCC increases with decreasing ECMO flow indicating higher concordance between MAP and HbO 2 and demonstrating loss of cerebral autoregulation at low ECMO flows. Statistically significant differences in WCC were observed between channels placed on the right and left scalp with channels on the right exhibiting higher values of WCC suggesting that the right hemisphere was more susceptible to disruption of cerebral autoregulation. Multichannel NIRS in conjunction with wavelet analysis methods can be used to assess regional variations in dynamic cerebral autoregulation with important clinical application in the management of critically ill children on life support systems.

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Regional cerebral oxygenation measured by multichannel near-infrared spectroscopy (optical topography) in an infant supported on venoarterial extracorporeal membrane oxygenation

Cited by 8 publications

References 5 publications

Wavelet Cross-Correlation to Investigate Regional Variations in Cerebral Oxygenation in Infants Supported on Extracorporeal Membrane Oxygenation

Wavelet Cross-Correlation to Investigate Regional Variations in Cerebral Oxygenation in Infants Supported on Extracorporeal Membrane Oxygenation

Brain Injury in Extracorporeal Membrane Oxygenation: A Multidisciplinary Approach

Multichannel near infrared spectroscopy indicates regional variations in cerebral autoregulation in infants supported on extracorporeal membrane oxygenation

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