Short-term moderate hypocapnia augments detection of optimal cerebral perfusion pressure.
Détails
ID Serval
serval:BIB_88710FBDF119
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Short-term moderate hypocapnia augments detection of optimal cerebral perfusion pressure.
Périodique
Journal of Neurotrauma
ISSN
1557-9042 (Electronic)
ISSN-L
0897-7151
Statut éditorial
Publié
Date de publication
2011
Volume
28
Numéro
7
Pages
1133-1137
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
An autoregulation-oriented strategy has been proposed to guide neurocritical therapy toward the optimal cerebral perfusion pressure (CPPOPT). The influence of ventilation changes is, however, unclear. We sought to find out whether short-term moderate hypocapnia (HC) shifts the CPPOPT or affects its detection. Thirty patients with traumatic brain injury (TBI), who required sedation and mechanical ventilation, were studied during 20 min of normocapnia (5.1±0.4 kPa) and 30 min of moderate HC (4.4±3.0 kPa). Monitoring included bilateral transcranial Doppler of the middle cerebral arteries (MCA), invasive arterial blood pressure (ABP), and intracranial pressure (ICP). Mx -autoregulatory index provided a measure for the CPP responsiveness of MCA flow velocity. CPPOPT was assessed as the CPP at which autoregulation (Mx) was working with the maximal efficiency. During normocapnia, CPPOPT (left: 80.65±6.18; right: 79.11±5.84 mm Hg) was detectable in 12 of 30 patients. Moderate HC did not shift this CPPOPT but enabled its detection in another 17 patients (CPPOPT left: 83.94±14.82; right: 85.28±14.73 mm Hg). The detection of CPPOPT was achieved via significantly improved Mx-autoregulatory index and an increase of CPP mean. It appeared that short-term moderate HC augmented the detection of an optimum CPP, and may therefore usefully support CPP-guided therapy in patients with TBI.
Pubmed
Web of science
Création de la notice
04/10/2011 16:56
Dernière modification de la notice
20/08/2019 15:47