{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T19:24:03Z","timestamp":1778095443564,"version":"3.51.4"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012940","name":"Universit\u00e4tsklinikum T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012940","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Heart Vessels"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Although cerebral macrocirculation is routinely assessed postoperatively in infants in the pediatric intensive care unit, monitoring cerebral microcirculation is not yet a standard practice. Our objective was to investigate the correlation between parameters of cerebral macro- and microcirculation in children following cardiac surgery and compare them with patients after neurosurgical and abdominal procedures. We conducted a prospective observational study in infants who underwent congenital cardiac surgery, visceral surgery, and neurosurgical procedures to measure parameters of cerebral macro- and microcirculation. Doppler ultrasound of anterior cerebral artery was performed, along with measurements of microcirculatory parameters using O2C device. 89 infants were included in the study. Group 1 (<jats:italic>n<\/jats:italic>\u2009=\u200935) comprised children after corrective cardiac surgery, group 2 (<jats:italic>n<\/jats:italic>\u2009=\u200922), after aortopulmonary shunt procedures, group 3 (<jats:italic>n<\/jats:italic>\u2009=\u200911), after Glenn operations, and group 4 (<jats:italic>n<\/jats:italic>\u2009=\u200921), after abdominal or neurosurgical procedures. The systolic peak flow was significantly lower in groups 2 and 3 compared to groups 1 and 4, 52.3 and 56.7 versus 59.6 and 68.8\u00a0cm\/s, <jats:italic>p<\/jats:italic>\u2009=\u20090.01, respectively. Pulsatility index was higher in patients of group 2 compared to groups 1, 3 and 4, 2.5 vs. 1.3, 1.4, and 1.5 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), respectively. The cerebral blood flow in the staged palliation groups (2 and 3) was lower compared to groups 1 and 4, 203 and 236 vs. 250 and 262 AU, <jats:italic>p<\/jats:italic>\u2009=\u20090.045. Children undergoing staged palliation may show variations in cerebral macro- and microcirculation. Both approaches described in our study provide complementary information and can accordingly be utilized in the postoperative intensive care period. Future studies should focus on establishing reference values for macro- and microcirculation parameters across various patient populations.<\/jats:p>","DOI":"10.1007\/s00380-025-02549-z","type":"journal-article","created":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T08:58:39Z","timestamp":1748077119000},"page":"1058-1065","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Macro- and microcirculation characteristics in the territory of the anterior cerebral artery in infants with congenital heart diseases"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6335-0839","authenticated-orcid":false,"given":"Yordan Hristov","family":"Georgiev","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam","family":"Sch\u00f6ne-Leupolz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Nordmeyer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Schlensak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafal","family":"Berger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Fideler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin Ulrich","family":"Schuhmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Zipfel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Michel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Neunhoeffer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"issue":"12","key":"2549_CR1","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1007\/s00392-011-0355-7","volume":"100","author":"G Schwedler","year":"2011","unstructured":"Schwedler G, Lindinger A, Lange PE, Sax U, Olchvary J, Peters B, Bauer U, Hense HW (2011) Frequency and spectrum of congenital heart defects among live births in Germany\u202f: a study of the Competence Network for Congenital Heart Defects. Clin Res Cardiol 100(12):1111\u20131117","journal-title":"Clin Res Cardiol"},{"issue":"4","key":"2549_CR2","doi-asserted-by":"publisher","first-page":"141","DOI":"10.5830\/CVJA-2013-028","volume":"24","author":"JI Hoffman","year":"2013","unstructured":"Hoffman JI (2013) The global burden of congenital heart disease. Cardiovasc J Afr 24(4):141\u2013145","journal-title":"Cardiovasc J Afr"},{"issue":"25","key":"2549_CR3","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","volume":"76","author":"GA Roth","year":"2020","unstructured":"Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, Barengo NC, Beaton AZ, Benjamin EJ, Benziger CP, Bonny A, Brauer M, Brodmann M, Cahill TJ, Carapetis J, Catapano AL, Chugh SS, Cooper LT, Coresh J, Criqui M et al (2020) Global burden of cardiovascular diseases and risk factors, 1990\u20132019: update from the GBD 2019 study. J Am Coll Cardiol 76(25):2982\u20133021","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"2549_CR4","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1016\/S0735-1097(01)01272-4","volume":"37","author":"CA Warnes","year":"2001","unstructured":"Warnes CA, Liberthson R, Danielson GK, Dore A, Harris L, Hoffman JI, Somerville J, Williams RG, Webb GD (2001) Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 37(5):1170\u20131175","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"2549_CR5","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1097\/MOP.0b013e328365342e","volume":"25","author":"BS Marino","year":"2013","unstructured":"Marino BS (2013) New concepts in predicting, evaluating, and managing neurodevelopmental outcomes in children with congenital heart disease. Curr Opin Pediatr 25(5):574\u2013584","journal-title":"Curr Opin Pediatr"},{"issue":"10","key":"2549_CR6","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1111\/pan.12705","volume":"25","author":"LM Zabala","year":"2015","unstructured":"Zabala LM, Guzzetta NA (2015) Cyanotic congenital heart disease (CCHD): focus on hypoxemia, secondary erythrocytosis, and coagulation alterations. Paediatr Anaesth 25(10):981\u2013989","journal-title":"Paediatr Anaesth"},{"issue":"3","key":"2549_CR7","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1067\/mtc.2002.122307","volume":"124","author":"HH H\u00f6vels-G\u00fcrich","year":"2002","unstructured":"H\u00f6vels-G\u00fcrich HH, Seghaye MC, Schnitker R, Wiesner M, Huber W, Minkenberg R, Kotlarek F, Messmer BJ, Von Bernuth G (2002) Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 124(3):448\u2013458","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"6","key":"2549_CR8","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1542\/peds.108.6.1325","volume":"108","author":"C Limperopoulos","year":"2001","unstructured":"Limperopoulos C, Majnemer A, Shevell MI, Rosenblatt B, Rohlicek C, Tchervenkov C, Darwish HZ (2001) Functional limitations in young children with congenital heart defects after cardiac surgery. Pediatrics 108(6):1325\u20131331","journal-title":"Pediatrics"},{"issue":"1","key":"2549_CR9","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.jpeds.2005.08.036","volume":"148","author":"A Majnemer","year":"2006","unstructured":"Majnemer A, Limperopoulos C, Shevell M, Rosenblatt B, Rohlicek C, Tchervenkov C (2006) Long-term neuromotor outcome at school entry of infants with congenital heart defects requiring open-heart surgery. J Pediatr 148(1):72\u201377","journal-title":"J Pediatr"},{"issue":"1","key":"2549_CR10","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1177\/2150135111418257","volume":"3","author":"JB Clark","year":"2012","unstructured":"Clark JB, Barnes ML, Undar A, Myers JL (2012) Multimodality neuromonitoring for pediatric cardiac surgery: our approach and a critical appraisal of the available evidence. World J Pediatr Congenit Heart Surg 3(1):87\u201395","journal-title":"World J Pediatr Congenit Heart Surg"},{"issue":"2","key":"2549_CR11","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1097\/01.PCC.0000257101.37171.BE","volume":"8","author":"PS McQuillen","year":"2007","unstructured":"McQuillen PS, Nishimoto MS, Bottrell CL, Fineman LD, Hamrick SE, Glidden DV, Azakie A, Adatia I, Miller SP (2007) Regional and central venous oxygen saturation monitoring following pediatric cardiac surgery: concordance and association with clinical variables. Pediatr Crit Care Med 8(2):154\u2013160","journal-title":"Pediatr Crit Care Med"},{"issue":"5","key":"2549_CR12","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1093\/bja\/aeh120","volume":"92","author":"M Hayashida","year":"2004","unstructured":"Hayashida M, Kin N, Tomioka T, Orii R, Sekiyama H, Usui H, Chinzei M, Hanaoka K (2004) Cerebral ischaemia during cardiac surgery in children detected by combined monitoring of BIS and near-infrared spectroscopy. Br J Anaesth 92(5):662\u2013669","journal-title":"Br J Anaesth"},{"issue":"1","key":"2549_CR13","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.jtcvs.2003.08.021","volume":"127","author":"GM Hoffman","year":"2004","unstructured":"Hoffman GM, Stuth EA, Jaquiss RD, Vanderwal PL, Staudt SR, Troshynski TJ, Ghanayem NS, Tweddell JS (2004) Changes in cerebral and somatic oxygenation during stage 1 palliation of hypoplastic left heart syndrome using continuous regional cerebral perfusion. J Thorac Cardiovasc Surg 127(1):223\u2013233","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"4","key":"2549_CR14","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1038\/s41390-022-01995-z","volume":"96","author":"ML Hansen","year":"2024","unstructured":"Hansen ML, Hyttel-S\u00f8rensen S, Jakobsen JC, Gluud C, Kooi EMW, Mintzer J, de Boode WP, Fumagalli M, Alarcon A, Alderliesten T, Greisen G, European Society for Paediatric Research Special Interest Group \u2018NearInfraRed Spectroscopy\u2019 (NIRS) (2024) Cerebral near-infrared spectroscopy monitoring (NIRS) in children and adults: a systematic review with meta-analysis. Pediatr Res 96(4):856\u2013867","journal-title":"Pediatr Res"},{"issue":"2","key":"2549_CR15","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1227\/NEU.0b013e3182178bc9","volume":"69","author":"KU Klein","year":"2011","unstructured":"Klein KU, Stadie A, Fukui K, Schramm P, Werner C, Oertel J, Engelhard K, Fischer G (2011) Measurement of cortical microcirculation during intracranial aneurysm surgery by combined laser-Doppler flowmetry and photospectrometry. Neurosurgery 69(2):391\u2013398","journal-title":"Neurosurgery"},{"key":"2549_CR16","first-page":"197","volume":"Suppl 81","author":"B Walter","year":"2002","unstructured":"Walter B, Bauer R, Krug A, Derfuss T, Traichel F, Sommer N (2002) Simultaneous measurement of local cortical blood flow and tissue oxygen saturation by Near infra-red Laser Doppler flowmetry and remission spectroscopy in the pig brain. Acta Neurochir Suppl Suppl 81:197\u2013199","journal-title":"Acta Neurochir Suppl"},{"issue":"1","key":"2549_CR17","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1093\/icvts\/ivx080","volume":"25","author":"F Neunhoeffer","year":"2017","unstructured":"Neunhoeffer F, Sandner K, Wiest M, Haller C, Renk H, Kumpf M, Schlensak C, Hofbeck M (2017) Non-invasive assessment of cerebral oxygen metabolism following surgery of congenital heart disease. Interact Cardiovasc Thorac Surg 25(1):96\u2013102","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"8","key":"2549_CR18","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1111\/pan.12649","volume":"25","author":"F Neunhoeffer","year":"2015","unstructured":"Neunhoeffer F, Kumpf M, Renk H, Hanelt M, Berneck N, Bosk A, Gerbig I, Heimberg E, Hofbeck M (2015) Nurse-driven pediatric analgesia and sedation protocol reduces withdrawal symptoms in critically ill medical pediatric patients. Paediatr Anaesth 25(8):786\u2013794","journal-title":"Paediatr Anaesth"},{"issue":"1","key":"2549_CR19","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1097\/01.PCC.0000149318.40279.1A","volume":"6","author":"E Ista","year":"2005","unstructured":"Ista E, van Dijk M, Tibboel D, de Hoog M (2005) Assessment of sedation levels in pediatric intensive care patients can be improved by using the COMFORT \u201cbehaviour\u201d scale. Pediatr Crit Care Med 6(1):58\u201363","journal-title":"Pediatr Crit Care Med"},{"issue":"5","key":"2549_CR20","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/j.aucc.2017.07.006","volume":"31","author":"E Ista","year":"2018","unstructured":"Ista E, Te Beest H, van Rosmalen J, de Hoog M, Tibboel D, van Beusekom B, van Dijk M (2018) Sophia Observation withdrawal Symptoms-Paediatric Delirium scale: a tool for early screening of delirium in the PICU. Aust Crit Care 31(5):266\u2013273","journal-title":"Aust Crit Care"},{"issue":"17","key":"2549_CR21","doi-asserted-by":"publisher","first-page":"2511","DOI":"10.1111\/j.1365-2702.2009.02836.x","volume":"18","author":"E Ista","year":"2009","unstructured":"Ista E, de Hoog M, Tibboel D, van Dijk M (2009) Implementation of standard sedation management in paediatric intensive care: effective and feasible? J Clin Nurs 18(17):2511\u20132520","journal-title":"J Clin Nurs"},{"issue":"4","key":"2549_CR22","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.bja.2018.12.019","volume":"122","author":"T Koponen","year":"2019","unstructured":"Koponen T, Karttunen J, Musialowicz T, Pietil\u00e4inen L, Uusaro A, Lahtinen P (2019) Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery. Br J Anaesth 122(4):428\u2013436","journal-title":"Br J Anaesth"},{"issue":"1","key":"2549_CR23","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1067\/mtc.2002.119064","volume":"123","author":"KJ Jenkins","year":"2002","unstructured":"Jenkins KJ, Gauvreau K, Newburger JW, Spray TL, Moller JH, Iezzoni LI (2002) Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 123(1):110\u2013118","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"9","key":"2549_CR24","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1161\/STROKEAHA.109.575167","volume":"41","author":"KM Brady","year":"2010","unstructured":"Brady KM, Mytar JO, Lee JK, Cameron DE, Vricella LA, Thompson WR, Hogue CW, Easley RB (2010) Monitoring cerebral blood flow pressure autoregulation in pediatric patients during cardiac surgery. Stroke 41(9):1957\u20131962","journal-title":"Stroke"},{"issue":"4","key":"2549_CR25","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1179\/1743132812Y.0000000145","volume":"35","author":"R Blaine Easley","year":"2013","unstructured":"Blaine Easley R, Kibler KK, Brady KM, Joshi B, Ono M, Brown C, Hogue CW (2013) Continuous cerebrovascular reactivity monitoring and autoregulation monitoring identify similar lower limits of autoregulation in patients undergoing cardiopulmonary bypass. Neurol Res 35(4):344\u2013354","journal-title":"Neurol Res"},{"issue":"1","key":"2549_CR26","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1097\/ANA.0b013e3181bea439","volume":"22","author":"KU Klein","year":"2010","unstructured":"Klein KU, Schramm P, Glaser M, Reisch R, Tresch A, Werner C, Engelhard K (2010) Intraoperative monitoring of cerebral microcirculation and oxygenation\u2014a feasibility study using a novel photo-spectrometric laser-Doppler flowmetry. J Neurosurg Anesthesiol 22(1):38\u201345","journal-title":"J Neurosurg Anesthesiol"},{"issue":"5","key":"2549_CR27","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1093\/bja\/aer227","volume":"107","author":"KU Klein","year":"2011","unstructured":"Klein KU, Fukui K, Schramm P, Stadie A, Fischer G, Werner C, Oertel J, Engelhard K (2011) Human cerebral microcirculation and oxygen saturation during propofol-induced reduction of bispectral index. Br J Anaesth 107(5):735\u2013741","journal-title":"Br J Anaesth"},{"issue":"4","key":"2549_CR28","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1152\/physrev.00022.2020","volume":"101","author":"JAHR Claassen","year":"2021","unstructured":"Claassen JAHR, Thijssen DHJ, Panerai RB, Faraci FM (2021) Regulation of cerebral blood flow in humans: physiology and clinical implications of autoregulation. Physiol Rev 101(4):1487\u20131559","journal-title":"Physiol Rev"},{"issue":"9","key":"2549_CR29","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1111\/anae.16313","volume":"79","author":"L Meng","year":"2024","unstructured":"Meng L, Sun Y, Zhao X, Rasmussen M, Al-Tarshan Y, Meng DM, Liu Z, Adams DC, McDonagh DL (2024) Noradrenaline-induced changes in cerebral blood flow in health, traumatic brain injury and critical illness: a systematic review with meta-analysis. Anaesthesia 79(9):978\u2013991","journal-title":"Anaesthesia"},{"issue":"2","key":"2549_CR30","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1177\/0310057X1704500212","volume":"45","author":"T Suemori","year":"2017","unstructured":"Suemori T, Horton SB, Bottrell S, Skowno JJ, Davidson A (2017) Changes in cerebral oxygen saturation and haemoglobin concentration during paediatric cardiac surgery. Anaesth Intensive Care 45(2):220\u2013227","journal-title":"Anaesth Intensive Care"},{"issue":"4","key":"2549_CR31","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1097\/ANA.0000000000000768","volume":"34","author":"M Castle-Kirszbaum","year":"2022","unstructured":"Castle-Kirszbaum M, Parkin WG, Goldschlager T, Lewis PM (2022) Cardiac output and cerebral blood flow: a systematic review of cardio-cerebral coupling. J Neurosurg Anesthesiol 34(4):352\u2013363","journal-title":"J Neurosurg Anesthesiol"},{"issue":"3","key":"2549_CR32","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1088\/0143-0815\/10\/3\/001","volume":"10","author":"LR Williams","year":"1989","unstructured":"Williams LR, Leggett RW (1989) Reference values for resting blood flow to organs of man. Clin Phys Physiol Meas 10(3):187\u2013217","journal-title":"Clin Phys Physiol Meas"},{"issue":"5","key":"2549_CR33","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1097\/ALN.0000000000000872","volume":"123","author":"L Meng","year":"2015","unstructured":"Meng L, Hou W, Chui J, Han R, Gelb AW (2015) Cardiac output and cerebral blood flow: the integrated regulation of brain perfusion in adult humans. Anesthesiology 123(5):1198\u20131208","journal-title":"Anesthesiology"},{"issue":"2","key":"2549_CR34","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1038\/pr.2015.227","volume":"79","author":"ES Peeples","year":"2016","unstructured":"Peeples ES, Mehic E, Mourad PD, Juul SE (2016) Fast Doppler as a novel bedside measure of cerebral perfusion in preterm infants. Pediatr Res 79(2):333\u2013338","journal-title":"Pediatr Res"},{"issue":"12","key":"2549_CR35","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1038\/jp.2014.122","volume":"34","author":"CJ Rhee","year":"2014","unstructured":"Rhee CJ, Fraser CD 3rd, Kibler K, Easley RB, Andropoulos DB, Czosnyka M, Varsos GV, Smielewski P, Rusin CG, Brady KM, Kaiser JR (2014) The ontogeny of cerebrovascular pressure autoregulation in premature infants. J Perinatol 34(12):926\u2013931","journal-title":"J Perinatol"},{"issue":"3","key":"2549_CR36","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/j.anclin.2016.04.002","volume":"34","author":"WM Armstead","year":"2016","unstructured":"Armstead WM (2016) Cerebral blood flow autoregulation and dysautoregulation. Anesthesiol Clin 34(3):465\u2013477","journal-title":"Anesthesiol Clin"},{"issue":"5","key":"2549_CR37","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.1002\/jmri.26978","volume":"51","author":"M Holmgren","year":"2020","unstructured":"Holmgren M, W\u00e5hlin A, Dun\u00e5s T, Malm J, Eklund A (2020) Assessment of cerebral blood flow pulsatility and cerebral arterial compliance with 4D flow MRI. J Magn Reson Imaging 51(5):1516\u20131525","journal-title":"J Magn Reson Imaging"},{"issue":"1","key":"2549_CR38","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s12028-012-9672-6","volume":"17","author":"N de Riva","year":"2012","unstructured":"de Riva N, Budohoski KP, Smielewski P, Kasprowicz M, Zweifel C, Steiner LA, Reinhard M, F\u00e1bregas N, Pickard JD, Czosnyka M (2012) Transcranial Doppler pulsatility index: what it is and what it isn\u2019t. Neurocrit Care 17(1):58\u201366","journal-title":"Neurocrit Care"},{"issue":"4","key":"2549_CR39","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1097\/00008506-199910000-00007","volume":"11","author":"XD Ma","year":"1999","unstructured":"Ma XD, Hauerberg J, Pedersen DB, Juhler M (1999) Effects of morphine on cerebral blood flow autoregulation CO2-reactivity in experimental subarachnoid hemorrhage. J Neurosurg Anesthesiol 11(4):264\u2013272","journal-title":"J Neurosurg Anesthesiol"},{"issue":"3","key":"2549_CR40","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1159\/000093489","volume":"90","author":"AA van Alfen-van der Velden","year":"2006","unstructured":"van Alfen-van der Velden AA, Hopman JC, Klaessens JH, Feuth T, Sengers RC, Liem KD (2006) Effects of midazolam and morphine on cerebral oxygenation and hemodynamics in ventilated premature infants. Biol Neonate 90(3):197\u2013202","journal-title":"Biol Neonate"},{"issue":"5","key":"2549_CR41","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1213\/ANE.0b013e3181f42fc0","volume":"111","author":"Y Ogawa","year":"2010","unstructured":"Ogawa Y, Iwasaki K, Aoki K, Gokan D, Hirose N, Kato J, Ogawa S (2010) The different effects of midazolam and propofol sedation on dynamic cerebral autoregulation. Anesth Analg 111(5):1279\u20131284","journal-title":"Anesth Analg"}],"container-title":["Heart and Vessels"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00380-025-02549-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00380-025-02549-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00380-025-02549-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:03:09Z","timestamp":1760644989000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00380-025-02549-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,24]]},"references-count":41,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["2549"],"URL":"https:\/\/doi.org\/10.1007\/s00380-025-02549-z","relation":{},"ISSN":["0910-8327","1615-2573"],"issn-type":[{"value":"0910-8327","type":"print"},{"value":"1615-2573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,24]]},"assertion":[{"value":"28 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national guidelines on human experimentation and with the Helsinki Declaration of 1975 revised in 2008. This study obtained official approval from the Ethics Committee at the Faculty of Medicine, University of T\u00fcbingen (574\/2012BO1).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}