Evaluation of cerebral autoregulation in dogs via transcranial color-coded duplex sonography and transient hyperemia testing.

Pablo A Donati, Lisa Tarragona, Andrea S Zaccagnini, Nestor M Nigro, Alfredo J Díaz, Santiago E Fuensalida, Ignacio Sández Cordero, Ignacio M Espiñeira, Pablo E Otero
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Abstract

Objective: To evaluate the changes in flow velocities of the middle cerebral artery before and after a carotid compression maneuver using transcranial color-coded duplex sonography (TCCD) in healthy anesthetized dogs under mechanical ventilation.

Design: Prospective study.

Setting: University teaching hospital.

Animals: Eleven healthy adult dogs.

Interventions: A 5-second carotid occlusion maneuver was performed to evaluate cerebral autoregulation (CA).

Measurements and main results: After 10 minutes of stable anesthesia, the middle cerebral artery was evaluated by TCCD. Dogs were positioned in sternal recumbency with the head raised to the level of the phlebostatic axis. The systolic peak velocity (Vp) was measured using pulsed Doppler mode. CA was evaluated through the transient hyperemia test (THT), which assesses changes in the Vp after a 5-second transient compression of the ipsilateral common carotid artery and is expressed as the ratio between the Vp flow before and after carotid compression. The Vp before and after carotid occlusion was compared using the Wilcoxon signed-rank test. The median Vp of the middle cerebral artery after the carotid compression maneuver was significantly higher than the median Vp before compression (median [interquartile range, IQR]: 47.7 cm/s [34.3] vs 64.1 cm/s [24.4]; P = 0.003). The median THT obtained was 1.20 (IQR: 0.37).

Conclusions: The current study demonstrated a significant increase in the Vp of the middle cerebral artery after a 5-second temporary occlusion of the ipsilateral carotid artery in healthy anesthetized dogs under mechanical ventilation. These findings suggest that the noninvasive TCCD methodology could be valuable for assessing CA in dogs. Additional studies using this technique in neurocritical animals are required to confirm its usefulness.

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通过经颅彩色编码双工超声波检查和瞬时充血试验评估狗的大脑自动调节功能。
目的在机械通气的健康麻醉犬中,使用经颅彩色编码双工超声造影(TCCD)评估颈动脉压迫操作前后大脑中动脉血流速度的变化:设计:前瞻性研究:动物:11 只健康成年犬:干预措施干预措施:进行 5 秒钟颈动脉闭塞操作,以评估大脑自动调节(CA):麻醉稳定 10 分钟后,用 TCCD 评估大脑中动脉。将狗置于胸骨后位,头部抬高至咽喉轴水平。使用脉冲多普勒模式测量收缩期峰值速度(Vp)。CA 通过瞬时充血试验(THT)进行评估,该试验评估同侧颈总动脉受到 5 秒钟瞬时压迫后 Vp 的变化,并以压迫颈动脉前后 Vp 流量的比值表示。颈动脉闭塞前后的 Vp 采用 Wilcoxon 符号秩检验进行比较。颈动脉压迫操作后大脑中动脉的中位 Vp 明显高于压迫前的中位 Vp(中位数[四分位数间距,IQR]:47.7 厘米/秒[34.7 厘米/秒]):47.7 cm/s [34.3] vs 64.1 cm/s [24.4];P = 0.003)。获得的 THT 中位数为 1.20(IQR:0.37):目前的研究表明,在机械通气的健康麻醉犬中,同侧颈动脉被暂时闭塞 5 秒后,大脑中动脉的 Vp 会显著增加。这些研究结果表明,无创 TCCD 方法对评估狗的 CA 很有价值。需要在神经危重动物中使用该技术进行更多研究,以确认其实用性。
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