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American Physiological Society, American Journal of Physiology - Regulatory, Integrative and Comparative Physiology, 3(284), p. R853-R859, 2003

DOI: 10.1152/ajpregu.00601.2002

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A new two-breath technique for extracting the cerebrovascular response to arterial carbon dioxide

Journal article published in 2003 by Michael R. Edwards, Zigniew L. Topor, Richard L. Hughson ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Cerebrovascular autoregulation is evaluated from spontaneous fluctuations in mean flow velocity (MFV) by transcranial Doppler ultrasound of the middle cerebral artery (MCA) with respect to changes in arterial blood pressure (BPMCA), but the effects of spontaneous fluctuations in arterial Pco 2 on MFV have been largely ignored. Autoregressive moving average analysis (ARMA), a closed-loop system identification technique, was applied to data from nine healthy subjects during spontaneous breathing, during inspiration of 10% CO2 for two breaths once per minute for 4 min, and during sustained breathing of 7% CO2. Cerebrovascular resistance index (CVRi) was calculated (CVRi = BPMCA/MFV). Reliable estimates of gain for BPMCA → MFV were obtained for spontaneous breathing and the two-breath method. In contrast, reliable gain estimates for Pco 2 → MFV or Pco 2 → CVRi were achieved only under the two-breath method. Pco 2 → MFV gain was smaller with the two-breath method than during sustained 7% CO2 ( P < 0.05). BPMCA was elevated by 7% CO2 but not by the two-breath method. The closed-loop model provides insight into interactions between BPMCA and Pco 2 on cerebrovascular control, but reliable solutions for Pco 2effects with ARMA analysis require perturbation by the two-breath method.