Neurocritical Care

, Volume 30, Issue 1, pp 201–206 | Cite as

Noninvasive Monitoring of Dynamic Cerebrovascular Autoregulation and ‘Optimal Blood Pressure’ in Normal Adult Subjects

  • Paul Pham
  • Jessica Bindra
  • Anders Aneman
  • Alwin Chuan
  • John M. Worthington
  • Matthias JaegerEmail author
Original Article



Cerebrovascular autoregulation can be continuously monitored from slow fluctuations of arterial blood pressure (ABP) and regional cerebral oxygen saturation (rSO2). The purpose of this study was to evaluate the index of dynamic cerebrovascular autoregulation (TOx) and the associated ‘optimal’ ABP in normal adult healthy subjects.


Twenty-eight healthy volunteers were studied. TOx was calculated as the moving correlation coefficient between spontaneous fluctuations of ABP and rSO2. ABP was measured with the Finometer photoplethysmograph. The ABP with optimal autoregulation (ABPOPT) was also determined as the ABP level with the lowest associated TOx (opt-TOx).


Average rSO2 and TOx was 72.3 ± 2.9% and 0.05 ± 0.18, respectively. Two subjects had impaired autoregulation with a TOx > 0.3. The opt-TOx was − 0.1 ± 0.26. ABPOPT was 87.0 ± 16.7 mmHg. The difference between ABP and ABPOPT was − 0.3 ± 7.5 mmHg. In total, 44% of subjects had a deviation of ABP from ABPOPT exceeding 5 mmHg. ABPOPT ranged from 57 to 117 mmHg.


TOx in healthy volunteers on average displays intact autoregulation and ABP close to ABPOPT. However, some subjects have possible autoregulatory dysfunction or a significant deviation of ABP from ABPOPT, which may confer a susceptibility to neurological injury.


Cerebral autoregulation Optimal cerebral perfusion pressure Near-infrared spectroscopy Neuromonitoring 


Authors’ Contributions

PP, JB, and AA performed the experiments and data collection. AA, AC, JMW, and MJ planned and designed the study and obtained funding. PP, JB, AA, and MJ analysed the data. PP, JB, AA, AC, JMW, and MJ interpreted the results, drafted and finalized the manuscript.

Source of support

This study was supported by an infrastructure grant from the University of New South Wales.

Compliance with Ethical Standards

Conflict of interest

The authors declare they have no conflict of interest.

Ethical Approval

The Human Research Ethics Committee of South Western Sydney Local Health District approved this study (HREC/14/LPOOL/135). Written informed consent was obtained from each participating subject.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2018

Authors and Affiliations

  1. 1.South Western Sydney Clinical SchoolUniversity of New South WalesLiverpool BCAustralia
  2. 2.Department of Intensive Care MedicineLiverpool HospitalLiverpoolAustralia
  3. 3.Department of AnaesthesiaLiverpool HospitalLiverpoolAustralia
  4. 4.Department of NeurologyRoyal Prince Alfred HospitalCamperdownAustralia
  5. 5.Department of NeurosurgeryWollongong HospitalWollongongAustralia

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