Evidence map›Paper›PMID 40211007›Full record

ArticleScientific reports2025

Towards quantitative assessment of cerebrovascular autoregulation in human neonates using ultrafast ultrasound imaging.

Nikan Fakhari, Julien Aguet, Alison Howell, Minh Nguyen, Luc Mertens, Lynn Crawford, Maelys Venet, Christoph Haller, David Barron, John G Sled and 2 more

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Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Nikan FakhariDepartment of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
Julien AguetDepartment of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, ON, Canada.
Alison HowellDepartment of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.
Minh NguyenDepartment of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.
Luc MertensDepartment of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.
Lynn CrawfordDepartment of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Maelys VenetDepartment of Pediatrics, Division of Cardiology, The Hospital for Sick Children, Toronto, ON, Canada.
Christoph HallerDepartment of Surgery, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
David BarronDepartment of Surgery, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
John G SledDepartment of Medical Biophysics, University of Toronto, Toronto, ON, Canada.
Jérôme BarangerDepartment of Translational Medicine, The Hospital for Sick Children research institute, Toronto, ON, Canada.
Olivier VillemainDepartment of Medical Biophysics, University of Toronto, Toronto, ON, Canada. olivier.villemain@chu-bordeaux.fr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Newborns with congenital heart diseases requiring cardiopulmonary bypass (CPB) are at risk of neurodevelopmental impairment. The impact of deep hypothermia cardiopulmonary bypass (DH-CPB) on cerebrovascular autoregulation (CAR) that controls brain perfusion in the presence of blood pressure variation is not well understood. Recently, ultrafast power Doppler (UPD) showed potential to study CAR in neonates based on cerebral blood volume (CBV). However, since CAR relies mainly on arterial vasoconstriction/vasodilation, monitoring of brain perfusion variation based on CBV requires the discrimination of arterial from venous CBV. This study aims to use UPD combined with an algorithm for the discrimination of arteries and veins to monitor CAR during DH-CPB in neonates. Transfontanellar ultrafast power Doppler was performed in two groups of newborns: those undergoing deep hypothermic cardiopulmonary bypass with circulatory arrest (18-20 °C, n = 6, "DH group") and those undergoing full-flow CPB at mild hypothermia (32-34 °C, n = 6, "non-DH group"). Blood flow directionality was used to differentiate arterial compartments of CBV from venous CBV in specific brain regions where arterial and venous flows exhibit opposite directions. To study CAR, a linear mixed effect model was used to find the association between arterial CBV and mean arterial blood pressure (MAP). In the "non-DH group", we found a negative association between arterial CBV and MAP, indicating that an increase in MAP is associated with a decrease in arterial CBV (slope = -0.020 [Formula: see text], p = 0.047). Conversely, in the "DH group" no significant association was found such that arterial CBV remained stable as MAP increased (p = 0.314). We interpret the reduction in arterial CBV with increasing MAP in the "non-DH group" as an active arterial vasoconstriction triggered by CAR, whereas the lack of variation of arterial CBV in the DH group suggests impaired CAR response. Our findings highlight the potential of ultrafast ultrasound imaging for intra-operative CAR monitoring, paving the way for a better understanding of the impact of different types of CPB on cerebral perfusion.

Indexed as

Cerebrovascular CirculationHeart Defects, CongenitalHomeostasisBrainCardiopulmonary BypassCerebral Blood VolumeFemaleHumansInfant, NewbornMaleCardiac surgeryCerebrovascular autoregulationNeonatesPediatricsUltrafast ultrasound imaging

Identifiers

PMID40211007
PMCPMC11985991

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