keyword
MENU ▼
Read by QxMD icon Read
search

Cerebral perfusion pressure

keyword
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#1
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28416148/alterations-in-autonomic-cerebrovascular-control-after-spinal-cord-injury
#2
Dong-Il Kim, Can Ozan Tan
Among chronic cardiovascular and metabolic sequelae of spinal cord injury (SCI) is an up-to four-fold increase in the risk of ischemic and hemorrhagic stroke, suggesting that individuals with SCI cannot maintain stable cerebral perfusion. In able-bodied individuals, the cerebral vasculature is able to regulate cerebral perfusion in response to swings in arterial pressure (cerebral autoregulation), blood gases (cerebral vasoreactivity), and neural metabolic demand (neurovascular coupling). This ability depends, at least partly, on intact autonomic function, but high thoracic and cervical spinal cord injuries result in disruption of sympathetic and parasympathetic cerebrovascular control...
April 4, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28397372/k-channel-impairment-determines-sex-and-age-differences-in-epinephrine-mediated-outcomes-after-brain-injury
#3
William M Armstead, John Riley, Monica S Vavilala
Traumatic brain injury (TBI) is the leading cause of injury-related death in children, with boys and children under 4 years having particularly poor outcomes. Activation of ATP- and calcium-sensitive (KATP and KCa ) channels produces cerebrovasodilation and contributes to autoregulation, both of which are impaired after TBI, contributing to poor outcomes. Upregulation of the c-Jun-terminal kinase (JNK) isoform of mitogen-activated protein kinase produces K channel function impairment after CNS injury. Vasoactive agents can be used to normalize cerebral perfusion pressure...
April 11, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28395665/retinal-arterial-blood-flow-and-retinal-changes-in-patients-with-sepsis-preliminary-study-using-fluorescein-angiography
#4
Kristo Erikson, Janne Henrik Liisanantti, Nina Hautala, Juha Koskenkari, Remi Kamakura, Karl Heinz Herzig, Hannu Syrjälä, Tero Ilmari Ala-Kokko
BACKGROUND: Although tissue perfusion is often decreased in patients with sepsis, the relationship between macrohemodynamics and microcirculatory blood flow is poorly understood. We hypothesized that alterations in retinal blood flow visualized by angiography may be related to macrohemodynamics, inflammatory mediators, and retinal microcirculatory changes. METHODS: Retinal fluorescein angiography was performed twice during the first 5 days in the intensive care unit to observe retinal abnormalities in patients with sepsis...
April 10, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28389734/-intensive-care-treatment-of-traumatic-brain-injury-in-multiple-trauma-patients-decision-making-for-complex-pathophysiology
#5
H Trimmel, G Herzer, H Schöchl, W G Voelckel
Traumatic brain injury (TBI) and hemorrhagic shock due to uncontrolled bleeding are the major causes of death after severe trauma. Mortality rates are threefold higher in patients suffering from multiple injuries and additionally TBI. Factors known to impair outcome after TBI, namely hypotension, hypoxia, hypercapnia, acidosis, coagulopathy and hypothermia are aggravated by the extent and severity of extracerebral injuries. The mainstays of TBI intensive care may be, at least temporarily, contradictory to the trauma care concept for multiple trauma patients...
April 7, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28389601/anterior-cerebral-blood-velocity-and-end-tidal-co2-responses-to-exercise-differ-in-children-and-adults
#6
Lindsay A Ellis, Philip N Ainslie, Victoria A Armstrong, Laura Emily Morris, Ryan Gerard Simair, Nathan R Sletten, Christine M Tallon, Ali Mary McManus
Little is known about the response of the cerebrovasculature to acute exercise in children and how these responses might differ with adults. Therefore, we compared changes in middle cerebral artery blood velocity (MCAVmean), partial pressure of end-tidal carbon dioxide (PETCO2), blood pressure and ventilation (VE) in response to incremental exercise between children and adults. Thirteen children [aged 9±1 (SD) y] and 13 sex-matched adults [aged 25±4 y] completed a maximal exercise test during which MCAVmean, PETCO2 and VE were measured continuously...
April 7, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28385097/cerebral-perfusion-pressure-insults-and-associations-with-outcome-in-adult-traumatic-brain-injury
#7
Fabian Giza, Geert Meyfroidt, Ian Piper, Giuseppe Citerio, Iain Chambers, Per Enblad, Pelle Nilsson, Bart Feyen, Philippe Jorens, Andrew Maas, Martin Ulrich Schuhmann, Rob Donald, Laura Moss, Greet Van den Berghe, Bart Depreitere
The definition of cerebral perfusion pressure (CPP) secondary insults in severe traumatic brain injury remains unclear. The purpose of the present study is to visualize the association of intensity and duration of episodes below or above cerebral perfusion pressure thresholds and outcome. The analysis was based on prospectively collected minute-by-minute intracranial pressure (ICP) and blood pressure data and outcome from 259 adult patients. The relationship of episodes of CPP below or above a certain threshold for certain duration with the 6-month Glasgow Outcome Score was visualized, separately for episodes of active or deficient autoregulation (AR)...
April 7, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28383324/cerebral-autoregulation-oriented-therapy-at-the-bedside-a-comprehensive-review
#8
Lucia Rivera-Lara, Andres Zorrilla-Vaca, Romergryko G Geocadin, Ryan J Healy, Wendy Ziai, Marek A Mirski
This comprehensive review summarizes the evidence regarding use of cerebral autoregulation-directed therapy at the bedside and provides an evaluation of its impact on optimizing cerebral perfusion and associated functional outcomes. Multiple studies in adults and several in children have shown the feasibility of individualizing mean arterial blood pressure and cerebral perfusion pressure goals by using cerebral autoregulation monitoring to calculate optimal levels. Nine of these studies examined the association between cerebral perfusion pressure or mean arterial blood pressure being above or below their optimal levels and functional outcomes...
April 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28375909/syncope
#9
William P Cheshire
PURPOSE OF REVIEW: Syncope is a prevalent syndrome with diverse causes, which have in common a sudden transient failure of the autonomic nervous system to maintain blood pressure against the force of gravity at a level sufficient for cerebral perfusion. Neurally mediated syncope is an episodic phenomenon in which autonomic nervous system function is normal the rest of the time. Although relatively benign, syncope increases the risk for injury from falling and can substantially impair patients' quality of life...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28373858/enhanced-cholinergic-activity-improves-cerebral-blood-flow-during-orthostatic-stress
#10
Jorge M Serrador, Roy Freeman
Cerebral blood flow (CBF) and consequently orthostatic tolerance when upright depends on dilation of the cerebral vasculature in the face of reduced perfusion pressure associated with the hydrostatic gradient. However, it is still unclear if cholinergic activation plays a role in this dilation. To determine if enhancing central cholinergic activity with the centrally acting acetylcholinesterase inhibitor, physostigmine would increase CBF when upright compared to the peripherally acting acetylcholinesterase inhibitor, neostigmine, or saline...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28372905/apoe-%C3%AE%C2%B54-positive-patients-suffering-severe-traumatic-head-injury-are-more-prone-to-undergo-decompressive-hemicraniectomy
#11
Zandra Olivecrona, Lars-Owe D Koskinen
OBJECT: In this paper we tested the hypothesis if patients with severe traumatic brain injury and presence of the apolipoprotein E (APOE) ε4 allele are more prone to undergo the surgical procedure decompressive hemicraniectomy (DC) in order to bring the intracranial pressure (ICP) under control. METHODS: In this prospective consecutive study patients with sTBI were enrolled (n=48). Inclusion criteria were arrival to our level one trauma university hospital within 24h after trauma, patient age between 15 and 70years, Glasgow Coma Scale (GCS) score ≤8 at the time of intubation and sedation, an initial cerebral perfusion pressure >10mmHg...
March 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28369828/raised-intracranial-pressure-and-retinal-haemorrhages-in-childhood-encephalopathies
#12
Robert A Minns, Patricia A Jones, Anamika Tandon, Brian W Fleck, Alan O Mulvihill, Fiona C Minns
AIM: To explore the relationship between raised intracranial pressure (RICP) and retinal haemorrhages in traumatic and non-traumatic childhood encephalopathies. METHOD: A prospective study of 112 children (35 females and 77 males, age range 0.01mo-17y 8.3mo; mean 5y 8.6mo, median 4y 5.6mo) included 57 accidental traumatic brain injuries (ATBIs), 21 inflicted traumatic brain injuries (ITBIs), and 34 non-traumatic encephalopathy cases. Measurements included intracranial pressure (ICP), cerebral perfusion pressure, pressure-time index of ICP, and number, zone, and layer of retinal haemorrhages on retinal imaging...
March 29, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28361248/increased-risk-of-critical-cbf-levels-in-sah-patients-with-actual-cpp-below-calculated-optimal-cpp
#13
Ulf Johnson, Henrik Engquist, Anders Lewén, Tim Howells, Pelle Nilsson, Elisabeth Ronne-Engström, Elham Rostami, Per Enblad
BACKGROUND: Cerebral pressure autoregulation can be quantified with the pressure reactivity index (PRx), based on the correlation between blood pressure and intracranial pressure. Using PRx optimal cerebral perfusion pressure (CPPopt) can be calculated, i.e., the level of CPP where autoregulation functions best. The relation between cerebral blood flow (CBF) and CPPopt has not been examined. The objective was to assess to which extent CPPopt can be calculated in SAH patients and to investigate CPPopt in relation to CBF...
March 30, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28352965/dual-energy-ct-to-diagnose-pseudoedema-in-contrast-induced-encephalopathy-following-cerebral-angiography
#14
Gabriel L Pagani-Estévez, Deena M Nasr, Waleed Brinjikji, Avital Perry, Jennifer E Fugate
BACKGROUND: Contrast-induced encephalopathy (CIE) is a syndrome that may be clinically unrecognized and misdiagnosed as cerebral edema. METHODS: Case report and review. RESULTS: A 72-year-old woman was admitted for elective endovascular embolization of a 10-mm left anterior communicating artery aneurysm. One hour post-procedure, she acutely developed global aphasia. Emergent head computed tomography (CT) and computed tomography-angiography (CTA) showed high attenuation of the left hemispheric subarachnoid spaces interpreted as hemispheric edema; emergent magnetic resonance imaging revealed left hemispheric punctate infarcts...
March 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28346232/the-future-is-now-neuroprotection-during-cardiopulmonary-resuscitation
#15
Johanna C Moore, Jason A Bartos, Timothy R Matsuura, Demetris Yannopoulos
PURPOSE OF REVIEW: Survival with favorable neurological function after cardiac arrest remains low. The purpose of this review is to identify recent advances that focus on neuroprotection during cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Multiple strategies have been shown to enhance neuroprotection during CPR. Brain perfusion during CPR is increased with therapies such as active compression decompression CPR and intrathoracic pressure regulation that improve cardiac preload and decrease intracranial pressure...
March 24, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28342045/effects-of-an-alveolar-recruitment-maneuver-on-subdural-pressure-brain-swelling-and-mean-arterial-pressure-in-patients-undergoing-supratentorial-tumour-resection-a-randomized-crossover-study
#16
Alana M Flexman, Peter A Gooderham, Donald E Griesdale, Ruth Argue, Brian Toyota
PURPOSE: Although recruitment maneuvers have been advocated as part of a lung protective ventilation strategy, their effects on cerebral physiology during elective neurosurgery are unknown. Our objectives were to determine the effects of an alveolar recruitment maneuver on subdural pressure (SDP), brain relaxation score (BRS), and cerebral perfusion pressure among patients undergoing supratentorial tumour resection. METHODS: In this prospective crossover study, patients scheduled for resection of a supratentorial brain tumour were randomized to undergo either a recruitment maneuver (30 cm of water for 30 sec) or a "sham" maneuver (5 cm of water for 30 sec), followed by the alternative intervention after a 90-sec equilibration period...
March 24, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28338505/effects-of-hypertonic-saline-and-sodium-lactate-on-cortical-cerebral-microcirculation-and-brain-tissue-oxygenation
#17
Vlasta Dostalova, Jitka Schreiberova, Vlasta Dostalova, Jiri Paral, Jaroslav Kraus, Alena Ticha, Vera Radochova, Pavel Dostal
BACKGROUND: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model. METHODS: Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28330412/early-asymmetric-cardio-cerebral-causality-and-outcome-after-severe-traumatic-brain-injury
#18
Lei Gao, Peter Smieleweski, Marek Czosnyka, Ari Ercole
The brain and heart are two vital systems in health and disease, increasingly recognised as a complex, interdependent network with constant information flow in both directions. After severe traumatic brain injury (TBI), the causal, directed interactions between the brain, heart and autonomic nervous system have not been well established. Novel methods are needed to probe unmeasured, potentially prognostic information in complex biological networks that are not revealed via traditional means. In this study, we examined potential bi-directional causality between intracranial pressure (ICP), mean arterial pressure (MAP) and heart rate (HR) and its relationship to mortality in a 24-hour period early after TBI...
March 23, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28314624/cerebral-white-matter-hypoperfusion-increases-with-small-vessel-disease-burden-data-from-the-third-international-stroke-trial
#19
Francesco Arba, Grant Mair, Trevor Carpenter, Eleni Sakka, Peter A G Sandercock, Richard I Lindley, Domenico Inzitari, Joanna M Wardlaw
BACKGROUND: Leukoaraiosis is associated with impaired cerebral perfusion, but the effect of individual and combined small-vessel disease (SVD) features on white matter perfusion is unclear. METHODS: We studied patients recruited with perfusion imaging in the Third International Stroke Trial. We rated individual SVD features (leukoaraiosis, lacunes) and brain atrophy on baseline plain computed tomography or magnetic resonance imaging. Separately, we assessed white matter at the level of the lateral ventricles in the cerebral hemisphere contralateral to the stroke for visible areas of hypoperfusion (present or absent) on 4 time-based perfusion imaging parameters...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#20
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
March 16, 2017: Current Opinion in Pediatrics
keyword
keyword
73934
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"