TY - JOUR
T1 - Near-Infrared Spectroscopy-Derived Dynamic Cerebral Autoregulation in Experimental Human Endotoxemia-An Exploratory Study
AU - Eleveld, N.
AU - Hoedemaekers, C.W.E.
AU - van Kaam, C.R.
AU - Leijte, G.P.
AU - van den Brule, J.M.D.
AU - Pickkers, P.
AU - Aries, M.J.H.
AU - Maurits, N.M.
AU - Elting, J.W.J.
PY - 2021/9/10
Y1 - 2021/9/10
N2 - Cerebral perfusion may be altered in sepsis patients. However, there are conflicting findings on cerebral autoregulation (CA) in healthy participants undergoing the experimental endotoxemia protocol, a proxy for systemic inflammation in sepsis. In the current study, a newly developed near-infrared spectroscopy (NIRS)-based CA index is investigated in an endotoxemia study population, together with an index of focal cerebral oxygenation.& nbsp;Methods: Continuous-wave NIRS data were obtained from 11 healthy participants receiving a continuous infusion of bacterial endotoxin for 3 h ( NCT02922673) under extensive physiological monitoring. Oxygenated-deoxygenated hemoglobin phase differences in the (very)low frequency (VLF/LF) bands and the Tissue Saturation Index (TSI) were calculated at baseline, during systemic inflammation, and at the end of the experiment 7 h after the initiation of endotoxin administration.& nbsp;Results: The median (inter-quartile range) LF phase difference was 16.2?degrees (3.0-52.6 degrees) at baseline and decreased to 3.9 degrees(& nbsp;)(2.0-8.8 degrees) at systemic inflammation (p = 0.03). The LF phase difference increased from systemic inflammation to 27.6 degrees (12.7-67.5 degrees) at the end of the experiment (p = 0.005). No significant changes in VLF phase difference were observed. The TSI (mean +/- SD) increased from 63.7 & PLUSMN; 3.4% at baseline to 66.5 +/- 2.8% during systemic inflammation (p = 0.03) and remained higher at the end of the experiment (67.1 +/- 4.2%, p = 0.04). Further analysis did not reveal a major influence of changes in several covariates such as blood pressure, heart rate, PaCO2, and temperature, although some degree of interaction could not be excluded.& nbsp;Discussion: A reversible decrease in NIRS-derived cerebral autoregulation phase difference was seen after endotoxin infusion, with a small, sustained increase in TSI. These findings suggest that endotoxin administration in healthy participants reversibly impairs CA, accompanied by sustained microvascular vasodilation.
AB - Cerebral perfusion may be altered in sepsis patients. However, there are conflicting findings on cerebral autoregulation (CA) in healthy participants undergoing the experimental endotoxemia protocol, a proxy for systemic inflammation in sepsis. In the current study, a newly developed near-infrared spectroscopy (NIRS)-based CA index is investigated in an endotoxemia study population, together with an index of focal cerebral oxygenation.& nbsp;Methods: Continuous-wave NIRS data were obtained from 11 healthy participants receiving a continuous infusion of bacterial endotoxin for 3 h ( NCT02922673) under extensive physiological monitoring. Oxygenated-deoxygenated hemoglobin phase differences in the (very)low frequency (VLF/LF) bands and the Tissue Saturation Index (TSI) were calculated at baseline, during systemic inflammation, and at the end of the experiment 7 h after the initiation of endotoxin administration.& nbsp;Results: The median (inter-quartile range) LF phase difference was 16.2?degrees (3.0-52.6 degrees) at baseline and decreased to 3.9 degrees(& nbsp;)(2.0-8.8 degrees) at systemic inflammation (p = 0.03). The LF phase difference increased from systemic inflammation to 27.6 degrees (12.7-67.5 degrees) at the end of the experiment (p = 0.005). No significant changes in VLF phase difference were observed. The TSI (mean +/- SD) increased from 63.7 & PLUSMN; 3.4% at baseline to 66.5 +/- 2.8% during systemic inflammation (p = 0.03) and remained higher at the end of the experiment (67.1 +/- 4.2%, p = 0.04). Further analysis did not reveal a major influence of changes in several covariates such as blood pressure, heart rate, PaCO2, and temperature, although some degree of interaction could not be excluded.& nbsp;Discussion: A reversible decrease in NIRS-derived cerebral autoregulation phase difference was seen after endotoxin infusion, with a small, sustained increase in TSI. These findings suggest that endotoxin administration in healthy participants reversibly impairs CA, accompanied by sustained microvascular vasodilation.
KW - near-infrared spectroscopy
KW - human endotoxemia model
KW - dynamic cerebral autoregulation
KW - sepsis
KW - cerebral perfusion
KW - BLOOD-FLOW
KW - SEPSIS
U2 - 10.3389/fneur.2021.695705
DO - 10.3389/fneur.2021.695705
M3 - Article
C2 - 34566840
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 695705
ER -