期刊
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
卷 33, 期 2, 页码 235-243出版社
SAGE PUBLICATIONS INC
DOI: 10.1038/jcbfm.2012.161
关键词
critical closing pressure; mathematical modeling; transcranial Doppler; wall tension; zero-flow pressure
资金
- National Institute of Health Research, Biomedical Research Center (Neuroscience Theme)
- Medical Research Council [G0600986, G9439390]
- Ministry of Science and Higher Education
- NIHR Senior Investigator Awards
- Neurosurgical Unit, University of Cambridge, UK
- MRC [G9439390, G0001237, G0600986] Funding Source: UKRI
- Medical Research Council [G0600986, G0001354, G1000183B, G0001237, G0001354B, G9439390] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0508-10327] Funding Source: researchfish
Critical closing pressure (CCP) is the arterial blood pressure (ABP) at which brain vessels collapse and cerebral blood flow (CBF) ceases. Using the concept of impedance to CBF, CCP can be expressed with brain-monitoring parameters: cerebral perfusion pressure (CPP), ABP, blood flow velocity (FV), and heart rate. The novel multiparameter method (CCPm) was compared with traditional transcranial Doppler (TCD) calculations of CCP (CCP1). Digital recordings of ABP, intracranial pressure (ICP), and TCD-based FV from previously published studies of 29 New Zealand White rabbits were reanalyzed. Overall, CCP1 and CCPm showed correlation across wide ranges of ABP, ICP, and PaCO2 (R = 0.93, P<0.001). Three physiological perturbations were studied: increase in ICP (n = 29) causing both CCP1 and CCPm to increase (P<0.001 for both); reduction of ABP (n = 10) resulting in decrease of CCP1 (P = 0.006) and CCPm (P = 0.002); and controlled increase of PaCO2 (n = 8) to hypercapnic levels, which decreased CCP1 and CCPm, albeit insignificantly (P = 0.123 and P = 0.306 respectively), caused by a spontaneous significant increase in ABP (P = 0.025). Multiparameter mathematical model of critical closing pressure explains the relationship of CCP on brain-monitoring variables, allowing the estimation of CCP during cases such as hypercapnia-induced hyperemia, where traditional calculations, like CCP1, often reach negative non-physiological values. Journal of Cerebral Blood Flow & Metabolism (2013) 33, 235-243; doi:10.1038/jcbfm.2012.161; published online 14 November 2012
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据