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Cerebral autoregulation

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https://www.readbyqxmd.com/read/29455690/effect-of-cerebral-perfusion-pressure-on-acute-respiratory-distress-syndrome
#1
Sonny Thiara, Donald E Griesdale, William R Henderson, Mypinder S Sekhon
BACKGROUND: Increased cerebral perfusion pressure (CPP)>70 mmHg has been associated with acute respiratory distress syndrome (ARDS) after traumatic brain injury (TBI). Since this reported association, significant changes in ventilation strategies and fluid management have been accepted as routine critical care. Recently, individualized perfusion targets using autoregulation monitoring suggest CPP titration>70 mmHg. Given these clinical advances, the association between ARDS and increased CPP requires further delineation...
February 19, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29454381/human-cerebrovascular-function-in-health-and-disease-insights-from-integrative-approaches
#2
REVIEW
Erin D Ozturk, Can Ozan Tan
BACKGROUND: The marked increase in the size of the brain, and consequently, in neural processing capability, throughout human evolution is the basis of the higher cognitive function in humans. However, greater neural, and thus information processing capability, comes at a significant metabolic cost; despite its relatively small size, the modern human brain consumes almost a quarter of the glucose and oxygen supply in the human body. Fortunately, several vascular mechanisms ensure sufficient delivery of glucose and oxygen to the active neural tissue (neurovascular coupling), prompt removal of neural metabolic by-products (cerebral vasoreactivity), and constant global blood supply despite daily variations in perfusion pressure (cerebral autoregulation)...
February 17, 2018: Journal of Physiological Anthropology
https://www.readbyqxmd.com/read/29454185/preterm-infants-undergoing-laparotomy-for-necrotizing-enterocolitis-or-spontaneous-intestinal-perforation-display-evidence-of-impaired-cerebrovascular-autoregulation
#3
Sara J Kuik, Michelle E van der Laan, Margot T Brouwer-Bergsma, Jan B F Hulscher, Anthony R Absalom, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Preterm infants requiring surgery are at risk of impaired neurocognitive development caused, possibly, by cerebral ischemia associated with impaired cerebrovascular autoregulation (CAR). We evaluated CAR before, during, and after laparotomy. STUDY DESIGN: This was a hypothesis generating prospective observational cohort study. SUBJECTS: We included preterm infants requiring surgery for necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP)...
February 14, 2018: Early Human Development
https://www.readbyqxmd.com/read/29452150/cerebral-blood-flow-velocity-and-autoregulation-in-paediatric-patients-following-a-global-hypoxic-ischaemic-insult
#4
Marlina E Lovett, Tensing Maa, Melissa G Chung, Nicole F O'Brien
AIM: To describe the cerebral blood flow velocity pattern and investigate cerebral autoregulation using transcranial Doppler ultrasonography (TCD) following a global hypoxic-ischaemic (HI) event in children. METHODS: This was a prospective, observational study in a quaternary-level paediatric intensive care unit. Intubated children, newborn to 17 years admitted to the PICU following HI injury (asphyxia, drowning, cardiac arrest) were eligible for inclusion. TCD was performed daily until post-injury day 8, discharge, or death, whichever occurred earliest...
February 13, 2018: Resuscitation
https://www.readbyqxmd.com/read/29437601/relationship-between-the-ambulatory-arterial-stiffness-index-and-the-lower-limit-of-cerebral-autoregulation-during-cardiac-surgery
#5
Yurie Obata, Viachaslau Barodka, Dan E Berkowitz, Allan Gottschalk, Charles W Hogue, Jochen Steppan
BACKGROUND: Pulse pressure, the ambulatory arterial stiffness index (AASI), and the symmetric AASI are established predictors of adverse cardiovascular outcomes. However, little is known about their relationship to cerebral autoregulation. This study evaluated whether these markers of vascular properties relate to the lower limit of cerebral autoregulation (LLA). METHODS AND RESULTS: The LLA was determined during cardiac surgery with transcranial Doppler ultrasonography in 181 patients...
February 8, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29432378/low-perfusion-pressure-is-associated-with-renal-tubular-injury-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-secondary-analysis-of-an-observational-study
#6
Mirela Bojan, Maria C Basto Duarte, Vanessa Lopez, Laurent Tourneur, Stephanie Vicca, Marc Froissart
BACKGROUND: Earlier work on adults undergoing surgery with cardiopulmonary bypass suggests that there is a close relationship between the lower limit of the cerebral and renal autoregulation pressures. Although cerebral autoregulation during bypass in infants has been extensively investigated, the impact of bypass on kidney function is not well known. It is, nevertheless, acknowledged that the main pathophysiological process involved in cardiac surgery-related kidney damage is tubular injury, and that urine neutrophil gelatinase-associated lipocaline (uNGAL) is a reliable biomarker of injury...
February 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29421451/intracranial-hypertension-and-cerebral-autoregulation-a-systematic-review-and-meta-analysis
#7
REVIEW
Marcelo de Lima Oliveira, Angela S M Salinet, Ricardo C Nogueira, Daniel S de Azevedo, Wellingson S Paiva, Manoel J Teixeira, Edson Bor-Seng-Shu
OBJECTIVE: The objective of this paper is to present a systematic review and meta-analysis to establish the relation between cerebral autoregulation (CA) and intracranial hypertension. METHODS: An electronic search using the term "Cerebral autoregulation and intracranial hypertension" was designed to identify studies that analyzed cerebral blood flow (CBF) autoregulation in patients undergoing intracranial pressure (ICP) monitoring. The data were used in meta-analyses and sensitivity analyses...
February 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29420157/dynamic-cerebral-autoregulation-during-cognitive-task-effect-of-hypoxia
#8
Shigehiko Ogoh, Hiroki Nakata, Tadayoshi Miyamoto, Damian M Bailey, Manabu Shibasaki
Changes in cerebral blood flow (CBF) subsequent to alterations in the partial pressures of oxygen and carbon dioxide can modify dynamic cerebral autoregulation (CA). While cognitive activity increases CBF, to what extent it impacts CA remains to be established. In the present study we determined if dynamic CA would decrease during a cognitive task and whether hypoxia would further compound impairment. Fourteen young healthy subjects performed a simple Go/No-go task during normoxia and hypoxia (FIO2 =12%) and the corresponding relationship between mean arterial pressure (MAP) and mean middle cerebral artery blood velocity (MCA Vmean) was examined...
February 8, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29419556/determining-the-upper-and-lower-limits-of-cerebral-autoregulation-with-cerebral-oximetry-autoregulation-curves-a-case-series
#9
Lucia Rivera-Lara, Andres Zorrilla-Vaca, Ryan J Healy, Wendy Ziai, Charles Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Marek A Mirski
OBJECTIVE: Critical care guidelines recommend a single target value for mean arterial blood pressure in critically ill patients. However, growing evidence regarding cerebral autoregulation challenges this concept and supports individualizing mean arterial blood pressure targets to prevent brain and kidney hypo- or hyperperfusion. Regional cerebral oxygen saturation derived from near-infrared spectroscopy is an acceptable surrogate for cerebral blood flow and has been validated to measure cerebral autoregulation...
February 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29417750/does-gradual-change-in-head-positioning-affect-cerebrovascular-physiology
#10
Man Y Lam, Victoria J Haunton, Thompson G Robinson, Ronney B Panerai
We studied cerebral blood velocity (CBV), and associated hemodynamic parameters during gradual changes in head positioning in a nonstroke group. CBV (transcranial Doppler ultrasound), beat-to-beat blood pressure (BP, Finometer), and end-tidal carbon dioxide (ETCO2 , capnography) were recorded between lying flat (0°) and sitting up (30°) head positions, in 18 volunteers (10 female, mean age, 57 ± 16 years), at two visits (12 ± 8 days). A significant reduction was found between 5-min FLAT (0°) and 5-min SIT (30°) positions in CBV (visit 1: 4...
February 2018: Physiological Reports
https://www.readbyqxmd.com/read/29410542/utility-of-prenatal-doppler-ultrasound-to-predict-neonatal-impaired-cerebral-autoregulation
#11
Sruthi R Polavarapu, Garrett D Fitzgerald, Stephen Contag, Suma B Hoffman
OBJECTIVE: Determine if abnormal prenatal Doppler ultrasound indices are predictive of postnatal impaired cerebral autoregulation. STUDY DESIGN: Prospective cohort study of 46 subjects, 240-296 weeks' gestation. Utilizing near-infrared spectroscopy and receiver-operating characteristic analysis, impaired cerebral autoregulation was defined as >16.5% time spent in a dysregulated state within 96 h of life. Normal and abnormal Doppler indices were compared for perinatal outcomes...
February 6, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29397783/estimating-pressure-reactivity-index-using-non-invasive-doppler-based-systolic-flow-index
#12
Frederick Adam Zeiler, Peter Smieleweski, Joseph Donnelly, Marek Czosnyka, David Menon, Ari Ercole
To derive models that estimate pressure reactivity index (PRx) using non-invasive transcranial Doppler (TCD) based systolic flow index (Sx_a) and mean flow index (Mx_a), both based on mean arterial pressure, in traumatic brain injury (TBI). Using a retrospective database of 347 TBI patients with ICP and TCD time series recordings we derived PRx, Sx_a and Mx_a. We first derived the autocorrelative structure of PRx based on: A. autoregressive integrative moving average (ARIMA) modelling in representative patients, and B...
February 3, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29394184/cerebral-autoregulation-in-the-prediction-of-delayed-cerebral-ischemia-and-clinical-outcome-in-poor-grade-aneurysmal-subarachnoid-hemorrhage-patients
#13
Max Gaasch, Alois J Schiefecker, Mario Kofler, Ronny Beer, Verena Rass, Bettina Pfausler, Claudius Thomé, Erich Schmutzhard, Raimund Helbok
OBJECTIVES: Pressure reactivity index and oxygen reactivity index are used to assess cerebral autoregulation after acute brain injury. The value of autoregulation indices in the prediction of delayed cerebral ischemia and outcome in patients with subarachnoid hemorrhage is still inconclusive. In this study, we aimed to focus on the predictive value of the first 72 hours commonly referred to as "early brain injury" in comparison to the overall monitoring period. DESIGN: Retrospective observational cohort study...
February 1, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29381724/non-linear-models-for-the-detection-of-impaired-cerebral-blood-flow-autoregulation
#14
Max Chacón, José Luis Jara, Rodrigo Miranda, Emmanuel Katsogridakis, Ronney B Panerai
The ability to discriminate between normal and impaired dynamic cerebral autoregulation (CA), based on measurements of spontaneous fluctuations in arterial blood pressure (BP) and cerebral blood flow (CBF), has considerable clinical relevance. We studied 45 normal subjects at rest and under hypercapnia induced by breathing a mixture of carbon dioxide and air. Non-linear models with BP as input and CBF velocity (CBFV) as output, were implemented with support vector machines (SVM) using separate recordings for learning and validation...
2018: PloS One
https://www.readbyqxmd.com/read/29379105/developmental-maturation-and-alpha-1-adrenergic-receptors-mediated-gene-expression-changes-in-ovine-middle-cerebral-arteries
#15
Dipali Goyal, Ravi Goyal
The Alpha Adrenergic Signaling Pathway is one of the chief regulators of cerebrovascular tone and cerebral blood flow (CBF), mediating its effects in the arteries through alpha1-adrenergic receptors (Alpha1AR). In the ovine middle cerebral artery (MCA), with development from a fetus to an adult, others and we have shown that Alpha1AR play a key role in contractile responses, vascular development, remodeling, and angiogenesis. Importantly, Alpha1AR play a significant role in CBF autoregulation, which is incompletely developed in a premature fetus as compared to a near-term fetus...
January 29, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29369096/electroencephalography-and-brain-oxygenation-monitoring-in-the-perioperative-period
#16
Thomas W L Scheeren, Merel H Kuizenga, Holger Maurer, Michel M R F Struys, Matthias Heringlake
Maintaining brain function and integrity is a pivotal part of anesthesiological practice. The present overview aims to describe the current role of the 2 most frequently used monitoring methods for evaluation brain function in the perioperative period, ie, electroencephalography (EEG) and brain oxygenation monitoring. Available evidence suggests that EEG-derived parameters give additional information about depth of anesthesia for optimizing anesthetic titration. The effects on reduction of drug consumption or recovery time are heterogeneous, but most studies show a reduction of recovery times if anesthesia is titrated along processed EEG...
January 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29369068/applications-of-near-infrared-spectroscopy-in-the-neonate
#17
Aisling A Garvey, Eugene M Dempsey
PURPOSE OF REVIEW: There has been a significant increase in the utilization of NIRS in neonatal care over the last few years, with some centers now routinely utilizing this monitoring technique for direct intervention at the bedside. In this review, we provide a summary of the most up-to-date evidence on near infrared spectroscopy utilization, with particular emphasis on measurement of cerebral oxygenation in preterm infants. RECENT FINDINGS: There have been significant advances in the technology, leading to an increase in the number of available devices and in the use of this monitoring tool to reduce cerebral injury in preterm infants...
January 22, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29362991/reduced-spontaneous-low-frequency-oscillations-as-measured-with-functional-near-infrared-spectroscopy-in-mild-cognitive-impairment
#18
Julia B M Zeller, Andrea Katzorke, Laura D Müller, Judith Breunig, Florian B Haeussinger, Jürgen Deckert, Bodo Warrings, Martin Lauer, Thomas Polak, Martin J Herrmann
Spontaneous low frequency oscillations (LFO) in functional imaging data have gained increased interest in the study of cognitive decline. Persons diagnosed with mild cognitive impairment (MCI) and Alzheimer's disease (AD) display alterations in their amount of LFO in various brain regions. This is commonly interpreted as disruptions in the autoregulation of the cerebral microvascular system. In the present study LFO (0,07-0,11 Hz) were measured with 52-channel near-infrared spectroscopy (NIRS) in 61 healthy elderly persons (70-76 years), 54 MCI subjects (70-76 years) and 25 healthy young controls (21-48 years) during rest over the frontal and the parietal cortex...
January 23, 2018: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/29354210/aggressive-blood-pressure-treatment-of-hypertensive-intracerebral-hemorrhage-may-lead-to-global-cerebral-hypoperfusion-case-report-and-imaging-perspective
#19
Jose Gavito-Higuera, Rakesh Khatri, Ihtesham A Qureshi, Alberto Maud, Gustavo J Rodriguez
Hypoperfusion injury related to blood pressure decrease in acute hypertensive intracerebral hemorrhage continues to be a controversial topic. Aggressive treatment is provided with the intent to stop the ongoing bleeding. However, there may be additional factors, including autoregulation and increased intracranial pressure, that may limit this approach. We present here a case of acute hypertensive intracerebral hemorrhage, in which aggressive blood pressure management to levels within the normal range led to global cerebral ischemia within multiple border zones...
December 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/29349952/estimation-of-cerebral-metabolic-rate-of-oxygen-consumption-using-combined-multiwavelength-photoacoustic-microscopy-and-doppler-microultrasound
#20
Yan Jiang, Roger Zemp
The metabolic rate of oxygen consumption is an important metric of tissue oxygen metabolism and is especially critical in the brain, yet few methods are available for measuring it. We use a custom combined photoacoustic-microultrasound system and demonstrate cerebral oxygen consumption estimation in vivo. In particular, the cerebral metabolic rate of oxygen consumption was estimated in a murine model during variation of inhaled oxygen from hypoxia to hyperoxia. The hypothesis of brain autoregulation was confirmed with our method even though oxygen saturation and flow in vessels changed...
January 2018: Journal of Biomedical Optics
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