Evaluation of a noninvasive transcranial doppler and blood pressure-based method for the assessment of cerebral perfusion pressure in pregnant women

Michael A. Belfort, Cathy Tooke-Miller, Michael Varner, George Saade, Charlotta Grunewald, Henry Nisell, J. Alan Herd

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Objective: We have developed a Doppler method for the estimation of cerebral perfusion pressure (CPP) using noninvasive techniques. Our objective was to evaluate our new method in pregnant women. Methods and Materials: Laboring women with a lumbar epidural in situ had transcranial Doppler interrogation of the maternal middle cerebral artery (MCA) to measure systolic, diastolic, and mean velocities. A pressure transducer was connected to the epidural catheter and pressure was recorded. Systolic (SBP), diastolic (DBP), and mean (MAP) blood pressure were taken with a Dinamap monitor. Doppler estimated CPP (mm Hg) = [V(mean)/(V(mean)-V(diastolic)](MAP - DBP) and directly measured CPP = MAP - Epidural pressure data were plotted on a Bland-Altman graph with limits of agreement. The mean difference (the mean of the sum of both positive and negative differences) and absolute difference (the mean of the sum of the absolute differences) were calculated. In addition, linear and polynomial regression analyses were performed. Results: Twenty laboring women were studied. All had normal pregnancies. The mean maternal age was 28 ± 7 years and the mean gestational age was 39 ± 2 weeks. The mean maternal MAP was 77 ± 12 mm Hg. The Bland-Airman plot showed a mean difference of 2.2 mm Hg at a mean CPP of 65 ± 12 mm Hg; with a standard deviation of 4.8 mm Hg, the absolute difference was 3.9 ± 3.0 mm Hg at a mean CPP of 65 ± 12 mm Hg. The regression analysis showed an r = 0.92, r2 = 0.86, and p < 0.0001. Conclusions: Our formula allows the estimation of CPP using a simple calculation and noninvasively acquired data. This method may be of use for frequent, easy, and accurate CPP and intracranial pressure estimation and may, as such, have significant research and clinical applications.

Original languageEnglish (US)
Pages (from-to)331-340
Number of pages10
JournalHypertension in Pregnancy
Volume19
Issue number3
DOIs
StatePublished - 2000

Fingerprint

Cerebrovascular Circulation
Pregnant Women
Blood Pressure
Regression Analysis
Mothers
Pressure Transducers
Pressure
Maternal Age
Middle Cerebral Artery
Intracranial Pressure
Gestational Age
Linear Models
Catheters
Pregnancy

Keywords

  • Brain
  • Cerebral perfusion pressure
  • Doppler
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Internal Medicine

Cite this

Evaluation of a noninvasive transcranial doppler and blood pressure-based method for the assessment of cerebral perfusion pressure in pregnant women. / Belfort, Michael A.; Tooke-Miller, Cathy; Varner, Michael; Saade, George; Grunewald, Charlotta; Nisell, Henry; Herd, J. Alan.

In: Hypertension in Pregnancy, Vol. 19, No. 3, 2000, p. 331-340.

Research output: Contribution to journalArticle

Belfort, Michael A. ; Tooke-Miller, Cathy ; Varner, Michael ; Saade, George ; Grunewald, Charlotta ; Nisell, Henry ; Herd, J. Alan. / Evaluation of a noninvasive transcranial doppler and blood pressure-based method for the assessment of cerebral perfusion pressure in pregnant women. In: Hypertension in Pregnancy. 2000 ; Vol. 19, No. 3. pp. 331-340.
@article{51e0962d3669495b83ad1378762fc6a1,
title = "Evaluation of a noninvasive transcranial doppler and blood pressure-based method for the assessment of cerebral perfusion pressure in pregnant women",
abstract = "Objective: We have developed a Doppler method for the estimation of cerebral perfusion pressure (CPP) using noninvasive techniques. Our objective was to evaluate our new method in pregnant women. Methods and Materials: Laboring women with a lumbar epidural in situ had transcranial Doppler interrogation of the maternal middle cerebral artery (MCA) to measure systolic, diastolic, and mean velocities. A pressure transducer was connected to the epidural catheter and pressure was recorded. Systolic (SBP), diastolic (DBP), and mean (MAP) blood pressure were taken with a Dinamap monitor. Doppler estimated CPP (mm Hg) = [V(mean)/(V(mean)-V(diastolic)](MAP - DBP) and directly measured CPP = MAP - Epidural pressure data were plotted on a Bland-Altman graph with limits of agreement. The mean difference (the mean of the sum of both positive and negative differences) and absolute difference (the mean of the sum of the absolute differences) were calculated. In addition, linear and polynomial regression analyses were performed. Results: Twenty laboring women were studied. All had normal pregnancies. The mean maternal age was 28 ± 7 years and the mean gestational age was 39 ± 2 weeks. The mean maternal MAP was 77 ± 12 mm Hg. The Bland-Airman plot showed a mean difference of 2.2 mm Hg at a mean CPP of 65 ± 12 mm Hg; with a standard deviation of 4.8 mm Hg, the absolute difference was 3.9 ± 3.0 mm Hg at a mean CPP of 65 ± 12 mm Hg. The regression analysis showed an r = 0.92, r2 = 0.86, and p < 0.0001. Conclusions: Our formula allows the estimation of CPP using a simple calculation and noninvasively acquired data. This method may be of use for frequent, easy, and accurate CPP and intracranial pressure estimation and may, as such, have significant research and clinical applications.",
keywords = "Brain, Cerebral perfusion pressure, Doppler, Pregnancy",
author = "Belfort, {Michael A.} and Cathy Tooke-Miller and Michael Varner and George Saade and Charlotta Grunewald and Henry Nisell and Herd, {J. Alan}",
year = "2000",
doi = "10.1081/PRG-100101995",
language = "English (US)",
volume = "19",
pages = "331--340",
journal = "Hypertension in Pregnancy",
issn = "1064-1955",
publisher = "Informa Healthcare",
number = "3",

}

TY - JOUR

T1 - Evaluation of a noninvasive transcranial doppler and blood pressure-based method for the assessment of cerebral perfusion pressure in pregnant women

AU - Belfort, Michael A.

AU - Tooke-Miller, Cathy

AU - Varner, Michael

AU - Saade, George

AU - Grunewald, Charlotta

AU - Nisell, Henry

AU - Herd, J. Alan

PY - 2000

Y1 - 2000

N2 - Objective: We have developed a Doppler method for the estimation of cerebral perfusion pressure (CPP) using noninvasive techniques. Our objective was to evaluate our new method in pregnant women. Methods and Materials: Laboring women with a lumbar epidural in situ had transcranial Doppler interrogation of the maternal middle cerebral artery (MCA) to measure systolic, diastolic, and mean velocities. A pressure transducer was connected to the epidural catheter and pressure was recorded. Systolic (SBP), diastolic (DBP), and mean (MAP) blood pressure were taken with a Dinamap monitor. Doppler estimated CPP (mm Hg) = [V(mean)/(V(mean)-V(diastolic)](MAP - DBP) and directly measured CPP = MAP - Epidural pressure data were plotted on a Bland-Altman graph with limits of agreement. The mean difference (the mean of the sum of both positive and negative differences) and absolute difference (the mean of the sum of the absolute differences) were calculated. In addition, linear and polynomial regression analyses were performed. Results: Twenty laboring women were studied. All had normal pregnancies. The mean maternal age was 28 ± 7 years and the mean gestational age was 39 ± 2 weeks. The mean maternal MAP was 77 ± 12 mm Hg. The Bland-Airman plot showed a mean difference of 2.2 mm Hg at a mean CPP of 65 ± 12 mm Hg; with a standard deviation of 4.8 mm Hg, the absolute difference was 3.9 ± 3.0 mm Hg at a mean CPP of 65 ± 12 mm Hg. The regression analysis showed an r = 0.92, r2 = 0.86, and p < 0.0001. Conclusions: Our formula allows the estimation of CPP using a simple calculation and noninvasively acquired data. This method may be of use for frequent, easy, and accurate CPP and intracranial pressure estimation and may, as such, have significant research and clinical applications.

AB - Objective: We have developed a Doppler method for the estimation of cerebral perfusion pressure (CPP) using noninvasive techniques. Our objective was to evaluate our new method in pregnant women. Methods and Materials: Laboring women with a lumbar epidural in situ had transcranial Doppler interrogation of the maternal middle cerebral artery (MCA) to measure systolic, diastolic, and mean velocities. A pressure transducer was connected to the epidural catheter and pressure was recorded. Systolic (SBP), diastolic (DBP), and mean (MAP) blood pressure were taken with a Dinamap monitor. Doppler estimated CPP (mm Hg) = [V(mean)/(V(mean)-V(diastolic)](MAP - DBP) and directly measured CPP = MAP - Epidural pressure data were plotted on a Bland-Altman graph with limits of agreement. The mean difference (the mean of the sum of both positive and negative differences) and absolute difference (the mean of the sum of the absolute differences) were calculated. In addition, linear and polynomial regression analyses were performed. Results: Twenty laboring women were studied. All had normal pregnancies. The mean maternal age was 28 ± 7 years and the mean gestational age was 39 ± 2 weeks. The mean maternal MAP was 77 ± 12 mm Hg. The Bland-Airman plot showed a mean difference of 2.2 mm Hg at a mean CPP of 65 ± 12 mm Hg; with a standard deviation of 4.8 mm Hg, the absolute difference was 3.9 ± 3.0 mm Hg at a mean CPP of 65 ± 12 mm Hg. The regression analysis showed an r = 0.92, r2 = 0.86, and p < 0.0001. Conclusions: Our formula allows the estimation of CPP using a simple calculation and noninvasively acquired data. This method may be of use for frequent, easy, and accurate CPP and intracranial pressure estimation and may, as such, have significant research and clinical applications.

KW - Brain

KW - Cerebral perfusion pressure

KW - Doppler

KW - Pregnancy

UR - http://www.scopus.com/inward/record.url?scp=0033709339&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033709339&partnerID=8YFLogxK

U2 - 10.1081/PRG-100101995

DO - 10.1081/PRG-100101995

M3 - Article

VL - 19

SP - 331

EP - 340

JO - Hypertension in Pregnancy

JF - Hypertension in Pregnancy

SN - 1064-1955

IS - 3

ER -