期刊
NEUROCRITICAL CARE
卷 21, 期 -, 页码 95-102出版社
HUMANA PRESS INC
DOI: 10.1007/s12028-014-0046-0
关键词
Autoregulation; Pressure reactivity; Cerebral perfusion pressure; Transcranial doppler ultrasound; Near-infrared spectroscopy; Cerebral blood flow
资金
- Medical Research Council [G0600986, G0601025, G9439390, G1002277, G0001237] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0508-10327, NIHR-RP-R3-12-013] Funding Source: researchfish
- MRC [G0001237, G1002277, G0600986, G0601025, G9439390] Funding Source: UKRI
- Medical Research Council [G9439390, G0600986, G0601025, G1002277, G0001237] Funding Source: Medline
- Department of Health [NIHR-RP-R3-12-013] Funding Source: Medline
Pressure autoregulation is an important hemodynamic mechanism that protects the brain against inappropriate fluctuations in cerebral blood flow in the face of changing cerebral perfusion pressure (CPP). Static autoregulation represents how far cerebrovascular resistance changes when CPP varies, and dynamic autoregulation represents how fast these changes happen. Both have been monitored in the setting of neurocritical care to aid prognostication and contribute to individualizing CPP targets in patients. Failure of autoregulation is associated with a worse outcome in various acute neurological diseases. Several studies have used transcranial Doppler ultrasound, intracranial pressure (ICP with vascular reactivity as surrogate measure of autoregulation), and near-infrared spectroscopy to continuously monitor the impact of spontaneous fluctuations in CPP on cerebrovascular physiology and to calculate derived variables of autoregulatory efficiency. Many patients who undergo such monitoring demonstrate a range of CPP in which autoregulatory efficiency is optimal. Management of patients at or near this optimal level of CPP is associated with better outcomes in traumatic brain injury. Many of these studies have utilized the concept of the pressure reactivity index, a correlation coefficient between ICP and mean arterial pressure. While further studies are needed, these data suggest that monitoring of autoregulation could aid prognostication and may help identify optimal CPP levels in individual patients.
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