期刊
BRITISH JOURNAL OF ANAESTHESIA
卷 128, 期 3, 页码 405-408出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.bja.2021.10.035
关键词
autoregulation; cardiac surgery; cerebral blood flow; cerebral injury; cerebral perfusion pressure; complications; delirium; near-infrared spectroscopy
资金
- US National Institutes of Health [R01 HL092259]
Growing evidence suggests that deviations of blood pressure from the limits of cerebral blood flow autoregulation can lead to complications in patients with neurological injury or undergoing cardiac surgery. Maintaining mean arterial pressure above the lower limit of cerebral autoregulation during cardiopulmonary bypass may reduce postoperative delirium and improve memory one month after surgery. Continuous measurement of blood pressure using a virtual patient monitoring platform offers potential for bringing this application to clinical practice.
A growing body of evidence demonstrates that excursions of BP below or above the limits of cerebral blood flow autoregulation are associated with complications in patients with neurological injury or for those undergoing cardiac surgery. Moreover, recent evidence suggests that maintaining MAP above the lower limit of cerebral autoregulation during cardiopulmonary bypass reduces the frequency of postoperative delirium and is associated with improved memory 1 month after surgery. Continuous measurement of BP in relation to cerebral autoregulation limits using a virtual patient monitoring platform processing near-infrared spectroscopy digital signals offers the hope of bringing this application to the bedside.
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