Wavelet and time-based cerebral autoregulation analysis using diffuse correlation spectroscopy on adults undergoing extracorporeal membrane oxygenation therapy
Adult patients who have suffered acute cardiac or pulmonary failure are increasingly being treated using extracorporeal membrane oxygenation (ECMO), a cardiopulmonary bypass technique. While ECMO has improved the long-term outcomes of these patients, neurological injuries can occur from underlying i...
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| Veröffentlicht in: | PloS one 2024-10, Vol.19 (10), p.e0299752 |
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| creator | Dar, Irfaan A Khan, Imad R Johnson, Thomas W Helmy, Samantha Marie Cardona, Jeronimo I Escobar, Samantha Selioutski, Olga Marinescu, Mark A Zhang, Chloe T Proctor, Ashley R AbdAllah, Noura Busch, David R Maddox, Ross K Choe, Regine |
| description | Adult patients who have suffered acute cardiac or pulmonary failure are increasingly being treated using extracorporeal membrane oxygenation (ECMO), a cardiopulmonary bypass technique. While ECMO has improved the long-term outcomes of these patients, neurological injuries can occur from underlying illness or ECMO itself. Cerebral autoregulation (CA) allows the brain to maintain steady perfusion during changes in systemic blood pressure. Dysfunctional CA is a marker of acute brain injury and can worsen neurologic damage. Monitoring CA using invasive modalities can be risky in ECMO patients due to the necessity of anticoagulation therapy. Diffuse correlation spectroscopy (DCS) measures cerebral blood flow continuously, noninvasively, at the bedside, and can monitor CA. In this study, we compare DCS-based markers of CA in veno-arterial ECMO patients with and without acute brain injury.
Adults undergoing ECMO were prospectively enrolled at a single tertiary hospital and underwent DCS and arterial blood pressure monitoring during ECMO. Neurologic injuries were identified using brain computerized tomography (CT) scans obtained in all patients. CA was calculated over a twenty-minute window via wavelet coherence analysis (WCA) over 0.05 Hz to 0.1 Hz and a Pearson correlation (DCSx) between cerebral blood flow measured by DCS and mean arterial pressure.
Eleven ECMO patients who received CT neuroimaging were recruited. 5 (45%) patients were found to have neurologic injury. CA indices WCOH, the area under the curve of the WCA, were significantly higher for patients with neurological injuries compared to those without neurological injuries (right hemisphere p = 0.041, left hemisphere p = 0.041). %DCSx, percentage of time DCSx was above a threshold 0.4, were not significantly higher (right hemisphere p = 0.268, left hemisphere p = 0.073).
DCS can be used to detect differences in CA for ECMO patients with neurological injuries compared to uninjured patients using WCA. |
| doi_str_mv | 10.1371/journal.pone.0299752 |
| format | Article |
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Adults undergoing ECMO were prospectively enrolled at a single tertiary hospital and underwent DCS and arterial blood pressure monitoring during ECMO. Neurologic injuries were identified using brain computerized tomography (CT) scans obtained in all patients. CA was calculated over a twenty-minute window via wavelet coherence analysis (WCA) over 0.05 Hz to 0.1 Hz and a Pearson correlation (DCSx) between cerebral blood flow measured by DCS and mean arterial pressure.
Eleven ECMO patients who received CT neuroimaging were recruited. 5 (45%) patients were found to have neurologic injury. CA indices WCOH, the area under the curve of the WCA, were significantly higher for patients with neurological injuries compared to those without neurological injuries (right hemisphere p = 0.041, left hemisphere p = 0.041). %DCSx, percentage of time DCSx was above a threshold 0.4, were not significantly higher (right hemisphere p = 0.268, left hemisphere p = 0.073).
DCS can be used to detect differences in CA for ECMO patients with neurological injuries compared to uninjured patients using WCA.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0299752</identifier><identifier>PMID: 39471182</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Adults ; Aged ; Anticoagulants ; Biological control systems ; Biology and Life Sciences ; Blood flow ; Blood oxygenation, Extracorporeal ; Blood pressure ; Brain ; Brain damage ; Brain injury ; Cerebral blood flow ; Cerebrovascular Circulation - physiology ; Coherence analysis ; Computed tomography ; Correlation ; Engineering and Technology ; Extracorporeal membrane oxygenation ; Extracorporeal Membrane Oxygenation - methods ; Female ; Head injuries ; Health aspects ; Hemispheric laterality ; Homeostasis ; Humans ; Injuries ; Injury analysis ; Lasers ; Male ; Medical imaging ; Medicine and Health Sciences ; Membranes ; Middle Aged ; Monitoring ; Neuroimaging ; Oxygenation ; Patient outcomes ; Physical Sciences ; Prospective Studies ; Research and Analysis Methods ; Spectroscopy ; Spectrum analysis ; Spectrum Analysis - methods ; Telemedicine ; Time series ; Tissues ; Traumatic brain injury ; Wavelet Analysis ; Wavelet transforms</subject><ispartof>PloS one, 2024-10, Vol.19 (10), p.e0299752</ispartof><rights>Copyright: © 2024 Dar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Dar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Dar et al 2024 Dar et al</rights><rights>2024 Dar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c460t-b821660e93ed6d97720f3b6f43302ea1b101bcbc94f18dc85f1a3ae6865687af3</cites><orcidid>0000-0001-5851-4504 ; 0000-0002-9488-944X ; 0000-0002-2017-605X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521301/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521301/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39471182$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Santulli, Gaetano</contributor><creatorcontrib>Dar, Irfaan A</creatorcontrib><creatorcontrib>Khan, Imad R</creatorcontrib><creatorcontrib>Johnson, Thomas W</creatorcontrib><creatorcontrib>Helmy, Samantha Marie</creatorcontrib><creatorcontrib>Cardona, Jeronimo I</creatorcontrib><creatorcontrib>Escobar, Samantha</creatorcontrib><creatorcontrib>Selioutski, Olga</creatorcontrib><creatorcontrib>Marinescu, Mark A</creatorcontrib><creatorcontrib>Zhang, Chloe T</creatorcontrib><creatorcontrib>Proctor, Ashley R</creatorcontrib><creatorcontrib>AbdAllah, Noura</creatorcontrib><creatorcontrib>Busch, David R</creatorcontrib><creatorcontrib>Maddox, Ross K</creatorcontrib><creatorcontrib>Choe, Regine</creatorcontrib><title>Wavelet and time-based cerebral autoregulation analysis using diffuse correlation spectroscopy on adults undergoing extracorporeal membrane oxygenation therapy</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Adult patients who have suffered acute cardiac or pulmonary failure are increasingly being treated using extracorporeal membrane oxygenation (ECMO), a cardiopulmonary bypass technique. While ECMO has improved the long-term outcomes of these patients, neurological injuries can occur from underlying illness or ECMO itself. Cerebral autoregulation (CA) allows the brain to maintain steady perfusion during changes in systemic blood pressure. Dysfunctional CA is a marker of acute brain injury and can worsen neurologic damage. Monitoring CA using invasive modalities can be risky in ECMO patients due to the necessity of anticoagulation therapy. Diffuse correlation spectroscopy (DCS) measures cerebral blood flow continuously, noninvasively, at the bedside, and can monitor CA. In this study, we compare DCS-based markers of CA in veno-arterial ECMO patients with and without acute brain injury.
Adults undergoing ECMO were prospectively enrolled at a single tertiary hospital and underwent DCS and arterial blood pressure monitoring during ECMO. Neurologic injuries were identified using brain computerized tomography (CT) scans obtained in all patients. CA was calculated over a twenty-minute window via wavelet coherence analysis (WCA) over 0.05 Hz to 0.1 Hz and a Pearson correlation (DCSx) between cerebral blood flow measured by DCS and mean arterial pressure.
Eleven ECMO patients who received CT neuroimaging were recruited. 5 (45%) patients were found to have neurologic injury. CA indices WCOH, the area under the curve of the WCA, were significantly higher for patients with neurological injuries compared to those without neurological injuries (right hemisphere p = 0.041, left hemisphere p = 0.041). %DCSx, percentage of time DCSx was above a threshold 0.4, were not significantly higher (right hemisphere p = 0.268, left hemisphere p = 0.073).
DCS can be used to detect differences in CA for ECMO patients with neurological injuries compared to uninjured patients using WCA.</description><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Anticoagulants</subject><subject>Biological control systems</subject><subject>Biology and Life Sciences</subject><subject>Blood flow</subject><subject>Blood oxygenation, Extracorporeal</subject><subject>Blood pressure</subject><subject>Brain</subject><subject>Brain damage</subject><subject>Brain injury</subject><subject>Cerebral blood flow</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Coherence analysis</subject><subject>Computed tomography</subject><subject>Correlation</subject><subject>Engineering and Technology</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Female</subject><subject>Head injuries</subject><subject>Health aspects</subject><subject>Hemispheric laterality</subject><subject>Homeostasis</subject><subject>Humans</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Lasers</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine and Health Sciences</subject><subject>Membranes</subject><subject>Middle Aged</subject><subject>Monitoring</subject><subject>Neuroimaging</subject><subject>Oxygenation</subject><subject>Patient outcomes</subject><subject>Physical Sciences</subject><subject>Prospective Studies</subject><subject>Research and Analysis Methods</subject><subject>Spectroscopy</subject><subject>Spectrum analysis</subject><subject>Spectrum Analysis - methods</subject><subject>Telemedicine</subject><subject>Time series</subject><subject>Tissues</subject><subject>Traumatic brain injury</subject><subject>Wavelet Analysis</subject><subject>Wavelet 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Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dar, Irfaan A</au><au>Khan, Imad R</au><au>Johnson, Thomas W</au><au>Helmy, Samantha Marie</au><au>Cardona, Jeronimo I</au><au>Escobar, Samantha</au><au>Selioutski, Olga</au><au>Marinescu, Mark A</au><au>Zhang, Chloe T</au><au>Proctor, Ashley R</au><au>AbdAllah, Noura</au><au>Busch, David R</au><au>Maddox, Ross K</au><au>Choe, Regine</au><au>Santulli, Gaetano</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Wavelet and time-based cerebral autoregulation analysis using diffuse correlation spectroscopy on adults undergoing extracorporeal membrane oxygenation therapy</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-10-29</date><risdate>2024</risdate><volume>19</volume><issue>10</issue><spage>e0299752</spage><pages>e0299752-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Adult patients who have suffered acute cardiac or pulmonary failure are increasingly being treated using extracorporeal membrane oxygenation (ECMO), a cardiopulmonary bypass technique. While ECMO has improved the long-term outcomes of these patients, neurological injuries can occur from underlying illness or ECMO itself. Cerebral autoregulation (CA) allows the brain to maintain steady perfusion during changes in systemic blood pressure. Dysfunctional CA is a marker of acute brain injury and can worsen neurologic damage. Monitoring CA using invasive modalities can be risky in ECMO patients due to the necessity of anticoagulation therapy. Diffuse correlation spectroscopy (DCS) measures cerebral blood flow continuously, noninvasively, at the bedside, and can monitor CA. In this study, we compare DCS-based markers of CA in veno-arterial ECMO patients with and without acute brain injury.
Adults undergoing ECMO were prospectively enrolled at a single tertiary hospital and underwent DCS and arterial blood pressure monitoring during ECMO. Neurologic injuries were identified using brain computerized tomography (CT) scans obtained in all patients. CA was calculated over a twenty-minute window via wavelet coherence analysis (WCA) over 0.05 Hz to 0.1 Hz and a Pearson correlation (DCSx) between cerebral blood flow measured by DCS and mean arterial pressure.
Eleven ECMO patients who received CT neuroimaging were recruited. 5 (45%) patients were found to have neurologic injury. CA indices WCOH, the area under the curve of the WCA, were significantly higher for patients with neurological injuries compared to those without neurological injuries (right hemisphere p = 0.041, left hemisphere p = 0.041). %DCSx, percentage of time DCSx was above a threshold 0.4, were not significantly higher (right hemisphere p = 0.268, left hemisphere p = 0.073).
DCS can be used to detect differences in CA for ECMO patients with neurological injuries compared to uninjured patients using WCA.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39471182</pmid><doi>10.1371/journal.pone.0299752</doi><tpages>e0299752</tpages><orcidid>https://orcid.org/0000-0001-5851-4504</orcidid><orcidid>https://orcid.org/0000-0002-9488-944X</orcidid><orcidid>https://orcid.org/0000-0002-2017-605X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-10, Vol.19 (10), p.e0299752 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3122113628 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Adults Aged Anticoagulants Biological control systems Biology and Life Sciences Blood flow Blood oxygenation, Extracorporeal Blood pressure Brain Brain damage Brain injury Cerebral blood flow Cerebrovascular Circulation - physiology Coherence analysis Computed tomography Correlation Engineering and Technology Extracorporeal membrane oxygenation Extracorporeal Membrane Oxygenation - methods Female Head injuries Health aspects Hemispheric laterality Homeostasis Humans Injuries Injury analysis Lasers Male Medical imaging Medicine and Health Sciences Membranes Middle Aged Monitoring Neuroimaging Oxygenation Patient outcomes Physical Sciences Prospective Studies Research and Analysis Methods Spectroscopy Spectrum analysis Spectrum Analysis - methods Telemedicine Time series Tissues Traumatic brain injury Wavelet Analysis Wavelet transforms |
| title | Wavelet and time-based cerebral autoregulation analysis using diffuse correlation spectroscopy on adults undergoing extracorporeal membrane oxygenation therapy |
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