Summary
The critical closing pressure (CrCP) of the cerebral vasculature is the arterial blood pressure (ABP) at which cerebral blood flow (CBF) ceases. Because the ABP of preterm infants is low and close to the CrCP, there is often no CBF during diastole. Thus, estimation of CrCP may become clinically relevant in preterm neonates. Transcranial Doppler (TCD) ultrasound has been used to estimate CrCP in preterm infants. Diffuse correlation spectroscopy (DCS) is a continuous, noninvasive optical technique that measures microvascular CBF. Our objective was to compare and validate CrCP measured by DCS versus TCD ultrasound. Hemorrhagic shock was induced in 13 neonatal piglets, and CBF was measured continuously by both modalities. CrCP was calculated using a model of cerebrovascular impedance, and CrCP determined by the two modalities showed good correlation by linear regression, median r 2 = 0.8 (interquartile range (IQR) 0.71–0.87), and Bland-Altman analysis showed a median bias of −3.5 (IQR −4.6 to −0.28). This is the first comparison of CrCP determined by DCS versus TCD ultrasound in a neonatal piglet model of hemorrhagic shock. The difference in CrCP between the two modalities may be due to differences in vasomotor tone within the microvasculature of the cerebral arterioles versus the macrovasculature of a major cerebral artery.
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Acknowledgments
C.J.R. is supported by the National Institutes of Health (1K23NS091382). D.R.R. is supported by the National Institutes of Health (1K23HLI130522). The technical assistance of Leticia McGuffey was greatly appreciated.
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Dr. Rusin has an significant financial interest in Medical Informatics Corp. MIC has no financial interests in this work.
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Elizondo, L.I. et al. (2021). Critical Closing Pressure by Diffuse Correlation Spectroscopy in a Neonatal Piglet Model. In: Depreitere, B., Meyfroidt, G., Güiza, F. (eds) Intracranial Pressure and Neuromonitoring XVII. Acta Neurochirurgica Supplement, vol 131. Springer, Cham. https://doi.org/10.1007/978-3-030-59436-7_55
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DOI: https://doi.org/10.1007/978-3-030-59436-7_55
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