The Sit-to-Stand Technique for the Measurement of Dynamic Cerebral Autoregulation

Farzaneh A. Sorond*, Jorge M. Serrador, Richard N. Jones, Michele L. Shaffer, Lewis A. Lipsitz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Scopus citations

Abstract

Measurement of cerebral autoregulation is important for the evaluation and management of a number of clinical disorders that affect cerebral blood flow. We currently lack simple bedside measures that mimic common physiologic stresses. Therefore, we evaluated a new sit-to-stand technique as an alternative method to the frequently-used thigh-cuff technique in healthy volunteers. Continuous middle cerebral artery (MCA) blood flow velocities (BFV) and arterial blood pressure (ABP) were measured in response to standing from a sitting position, or rapid thigh-cuff deflation in 24 healthy subjects (50 ± 22 y). Autoregulatory index (ARI) was calculated as the BFV response for step changes in ABP using a second-order differential equation with a set of parameters that can be used to grade the performance of autoregulation. Of these 24 subjects, 30% could tolerate only two thigh-cuffs and refused to proceed with the third cuff, whereas none of our subjects had any difficulty with performing the three sit-to-stand trials. The two techniques produced similar changes in mean ABP, but the times to nadir of the blood pressure and BFV were significantly faster for the thigh-cuff. The mean group ARIs were similar between the two techniques. Although between-subjects variability was higher for sit-to-stand ARIs, the within-subject sit-to-stand ARI variability was small. Thus, for the assessment of cerebral autoregulation, the sit-to-stand procedure is well tolerated and produces ARI values that have low within-subject variability. The sit-to-stand technique appears to be a suitable measure of individual ARI values for inferring dynamic cerebral autoregulation. E-mail: fsorond@partners.org.

Original languageEnglish (US)
Pages (from-to)21-29
Number of pages9
JournalUltrasound in Medicine and Biology
Volume35
Issue number1
DOIs
StatePublished - Jan 2009

Keywords

  • Dynamic cerebral autoregulation
  • Sit-to-stand procedure
  • Transcranial Doppler ultrasound

ASJC Scopus subject areas

  • Biophysics
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics

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