The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study

Bellapart, Judith, Chan, Gregory, Tzeng, Yu-Chieh, Ainslie, Philip, Barnett, Adrian, Dunster, Kimble, Boots, Robert, & Fraser, John (2011) The effect of Ventricular Assist Devices on cerebral autoregulation: A preliminary study. BMC Anesthesiology, pp. 1-8.

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Abstract

Background

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.

Methods

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).

Results

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, P = 0.04). The two cases with highest coherence (~0.8) also had much higher spectral power in mean arterial blood pressure.

Conclusions

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.

Impact and interest:

7 citations in Scopus
7 citations in Web of Science®
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ID Code: 52233
Item Type: Journal Article
Refereed: Yes
Keywords: Ventricular Assist Device, Cerebral Autoregulation, Intensive Care
DOI: 10.1186/1471-2253-11-4
ISSN: 1471-2253
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Intensive Care (110310)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL PHYSIOLOGY (111600)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Deposited On: 19 Jul 2012 06:28
Last Modified: 16 Jul 2017 07:01

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