A pilot study: Comparing a novel noninvasive measure of cerebrovascular stability index with an invasive measure of cerebral autoregulation in neonates with congenital heart disease

Carlin A Merkel; Kenneth M Brady; Jodie K Votava-Smith; Nhu N Tran

doi:10.1017/cts.2023.581

A pilot study: Comparing a novel noninvasive measure of cerebrovascular stability index with an invasive measure of cerebral autoregulation in neonates with congenital heart disease

J Clin Transl Sci. 2023 Jul 10;7(1):e165. doi: 10.1017/cts.2023.581. eCollection 2023.

Authors

Carlin A Merkel¹, Kenneth M Brady², Jodie K Votava-Smith^{1

3}, Nhu N Tran^{1

4}

Affiliations

¹ Keck School of Medicine, Los Angeles, CA, USA.
² Division of Cardiac Anesthesia, Northwestern University Feinberg School of Medicine and Ann & Robert H, Lurie Children's Hospital of Chicago, Chicago, IL, USA.
³ Division of Cardiology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.
⁴ Division of Neonatology, Department of Pediatrics, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.

Abstract

Infants with congenital heart disease (CHD) may have impaired cerebral autoregulation (CA) associated with cerebral fractional tissue oxygen extraction (FTOE). We conducted a pilot study in nine CHD neonates to validate a noninvasive CA measure, cerebrovascular stability index (CSI), by eliciting responses to postural tilts. We compared CSI to an invasive measure of CA and to FTOE collected during tilts (FTOE_Spot). FTOE_Spot correlated with CSI, as did the change in FTOE during tilts, but CSI's correlation with impaired CA did not reach significance. Larger trials are indicated to validate CSI, allowing for noninvasive CA measurements and measurements in outpatient settings.

Keywords: Cerebral autoregulation; cerebrovascular stability index; congenital heart disease; fractional tissue oxygen extraction; neonates.