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Breath-holding index – a new approach to an old method

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Nowakowska-Kotas M., Lisiak W., Wiśniewska E., Budrewicz S., Wiśniewski P.
European Journal of Translational and Clinical Medicine
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2025
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vol. 8
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issue 1
10-18
EN
Background Despite technical challenges and uncertainties, transcranial Doppler (TCD) ultrasonography remains a promising tool due to its non-invasive nature, safety, and cost-effectiveness. In this study we aimed to develop an advanced automatic calculation method for the breath-holding index (BHI) to enhance the reliability of cerebrovascular reactivity (CVR) measurements. Material and methods This study involved the automatic calculation of BHI during the breath-holding maneuver, targeting a reduction in variability and an increase in the accuracy of CVR assessment. Results The BHI_to_max method was identified as the most effective, which revealed the least variability. This method calculates the steepest slope of blood flow velocity change during CO2-induced vasodilation. By focusing on a minimized time interval and adjusting for potential shifts in the start and end points, this approach captures the most dynamic phase of the cerebrovascular response to CO2. Conclusions We propose an automatic calculation method, which accounts for individual differences in CO2 sensitivity and CVR. It offers a potentially more precise and personalized assessment of CVR, leading to a more reproducible and individualized measurement.
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