{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T11:42:38Z","timestamp":1778931758604,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,3,18]],"date-time":"2013-03-18T00:00:00Z","timestamp":1363564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Moyamoya syndrome carries a high risk of cerebral ischemia, and impaired cerebrovascular autoregulation may play a critical role. Autoregulation indices derived from near\u2010infrared spectroscopy (\n                      <jats:styled-content style=\"fixed-case\">NIRS<\/jats:styled-content>\n                      ) may clarify hemodynamic goals that conform to the limits of autoregulation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      The aims of this pilot study were to determine whether the\n                      <jats:styled-content style=\"fixed-case\">NIRS<\/jats:styled-content>\n                      \u2010derived indices could identify blood pressure ranges that optimize autoregulation and whether autoregulatory function differs between anatomic sides in patients with unilateral vasculopathy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Pediatric patients undergoing indirect surgical revascularization for moyamoya were enrolled sequentially.\n                      <jats:styled-content style=\"fixed-case\">NIRS<\/jats:styled-content>\n                      \u2010derived autoregulation indices, the cerebral oximetry index (\n                      <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>\n                      x) and the hemoglobin volume index (\n                      <jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content>\n                      x), were calculated intraoperatively and postoperatively to measure autoregulatory function. The 5\u2010mm\n                      <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>\n                      g ranges of optimal mean arterial blood pressure (\n                      <jats:styled-content style=\"fixed-case\">\n                        MAP\n                        <jats:sub>OPT<\/jats:sub>\n                      <\/jats:styled-content>\n                      ) with best autoregulation and the lower limit of autoregulation (\n                      <jats:styled-content style=\"fixed-case\">LLA<\/jats:styled-content>\n                      ) were identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of seven enrolled patients (aged 2\u201316\u00a0years), six had intraoperative and postoperative autoregulation monitoring and one had only intraoperative monitoring. Intraoperative\n                      <jats:styled-content style=\"fixed-case\">\n                        MAP\n                        <jats:sub>OPT<\/jats:sub>\n                      <\/jats:styled-content>\n                      was identified in six (86%) of seven patients with median values of 60\u201380\u00a0mm\n                      <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>\n                      g. Intraoperative\n                      <jats:styled-content style=\"fixed-case\">LLA<\/jats:styled-content>\n                      was identified in three (43%) patients with median values of 55\u201365\u00a0mm\n                      <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>\n                      g. Postoperative\n                      <jats:styled-content style=\"fixed-case\">\n                        MAP\n                        <jats:sub>OPT<\/jats:sub>\n                      <\/jats:styled-content>\n                      was identified in six (100%) of six patients with median values of 70\u201390\u00a0mmHg. Patients with unilateral disease had higher intraoperative\n                      <jats:styled-content style=\"fixed-case\">HV<\/jats:styled-content>\n                      x (\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\n                      <jats:italic>\u00a0<\/jats:italic>\n                      0.012) on side vasculopathy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">NIRS<\/jats:styled-content>\n                      \u2010derived indices may identify hemodynamic goals that optimize autoregulation in pediatric moyamoya.\n                    <\/jats:p>\n                  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