Model of dependence between arterial blood pressure and cerebral blood flow. State of the art and the new proposal / Model zależności pomiędzy tętniczym ciśnieniem krwi a mózgowym przepływem krwi. Stan wiedzy i nowa propozycja (176–187)
Autorzy: Renata Kalicka, Kamila Mazur
Cerebral autoregulation is a very important and complicated process to maintain adequate and stable cerebral blood flow. In current medical practice cerebral autoregulation is diagnosed using two measurements: cerebral blood flow (by Doppler Ultrasonography, Magnetic Resonance Imaging or Computed Tomography) and arterial blood pressure.
The aim of our study is to determine the dependence of the cerebral blood flow (CBF) on the mean arterial pressure (MAP) by measuring blood pressure and cerebral blood flow using modelling and data processing. The dependence will be presented as a curve based on the Strandgaard's observation of cerebral blood flow changes in response to changes in the mean arterial pressure. These observations we have described using polynomials of degree n = 3, 4, 5 and 6. The four curves were identified using least-squares fitting to Strandgaard's measurements. As the best of the considered curves of degree n = 3, 4, 5 and 6 we choose the one for which the Akaike Information Criterion AIC reaches a minimum. The criterion in the minimum finds compromise between the goodness of fit of the curve to the data and the curve complexity. Minimum of AIC was obtained for n = 4 (Kalicka&Mazur curve). The modelled dependence of CBF on MAP was used in CBF(MAP) simulations for important and typical pressure values: normotensive, hypertensive and patients under unexpected stress.
The model selected by the AIC informative criterion, degree n = 4, proved to be good candidate for describing CBF(MAP). This model (Kalicka&Mazur) gives CBF values which are comparable to those the measured for successive MAP values. The measured and the modelled Kalicka&Mazur curve CBF values differed less than the measured and the modelled CBF values of the Dirnagl&Pulsinelli curve and the Olsen curve.
Słowa kluczowe: model, cerebral blood flow, mean arterial pressure, Lassen's curve