title: Wavelet cross-correlation to investigate regional variations in cerebral oxygenation in infants supported on extracorporeal membrane oxygenation.
abstract: Extracorporeal membrane oxygenation can potentially affect cerebral blood flow dynamics and consequently influence cerebral autoregulation. We applied wavelet cross-correlation (WCC) between multichannel cerebral oxyhemoglobin concentration (HbO(2)) and mean arterial pressure (MAP), to assess regional variations in cerebral autoregulation. Six infants on veno-arterial (VA) ECMO were studied during sequential changes in the ECMO flows. WCC between MAP and HbO(2) for each flow period and each channel was calculated within three different frequency (wavelet scale) bands centered around 0.1, 0.16, and 0.3 Hz chosen to represent low frequency oscillations, ventilation, and respiration rates, respectively. The group data showed a relationship between maximum WCC and ECMO flow. During changes in ECMO flow, statistically significant differences in maximum WCC were found between right and left hemispheres. WCC between HbO(2) and MAP provides a useful method to investigate the dynamics of cerebral autoregulation during ECMO. Manipulations of ECMO flows are associated with regional changes in cerebral autoregulation which may potentially have an important bearing on clinical outcome.
authors.affiliation: Medical Physics and Bioengineering Department, University College London, Malet Place Engineering Building, Gower Street, London, WC1E 6BT, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Papademetriou
authors.affiliation: Medical Physics and Bioengineering Department, University College London, Malet Place Engineering Building, Gower Street, London, WC1E 6BT, UK.
authors.forename: Ilias
authors.initials: I
authors.lastname: Tachtsidis
authors.affiliation: Cardiothoracic Unit, Great Ormond Street Hospital for Children, London, UK.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Elliott
authors.affiliation: Cardiothoracic Unit, Great Ormond Street Hospital for Children, London, UK.
authors.forename: Aparna
authors.initials: A
authors.lastname: Hoskote
authors.affiliation: Medical Physics and Bioengineering Department, University College London, Malet Place Engineering Building, Gower Street, London, WC1E 6BT, UK. celwell@medphys.ucl.ac.uk.
authors.forename: Clare E
authors.initials: CE
authors.lastname: Elwell
mesh_terms: D000465:Algorithms; D062186:Arterial Pressure; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006706:Homeostasis; D006801:Humans; D007231:Infant, Newborn; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000378:metabolism*; D010108:Oxyhemoglobins / Q000378:metabolism; D012131:Respiratory Insufficiency / Q000517:prevention & control*; D058067:Wavelet Analysis
chemical_list: D010108:Oxyhemoglobins; D010100:Oxygen