Continuous assessment of cerebral autoregulation: clinical and laboratory experience.

Détails

ID Serval
serval:BIB_8BA2F7FDD370
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Continuous assessment of cerebral autoregulation: clinical and laboratory experience.
Périodique
Acta Neurochirurgica. Supplement
Auteur(s)
Czosnyka M., Smielewski P., Czosnyka Z., Piechnik S., Steiner L.A., Schmidt E., Gooskens I., Soehle M., Lang E.W., Matta B.F., Pickard J.D.
ISSN
0065-1419
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
86
Pages
581-585
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Résumé
The method for the continuous assessment of cerebral autoregulation using slow waves of MCA blood flow velocity (FV) and cerebral perfusion pressure (CPP) or arterial pressure (ABP) has been introduced seven years ago. We intend to review its clinical applications in various scenarios. Moving correlation coefficient (3-6 min window), named Mx, is calculated between low-pass filtered (0.05 Hz) signals of FV and CPP or ABP (when ICP is not measured directly). Data from ventilated 243 head injuries and 15 patients after poor grade subarachnoid haemorrhage, 38 patients with Carotid Artery stenosis, 35 patients with hydrocephalus and fourteen healthy volunteers is presented. Good agreement between the leg-cuff test and Mx has been confirmed in healthy volunteers (r = 0.81). Mx also correlated significantly with the static rate of autoregulation and transient hyperaemic response test. Autoregulation was disturbed (p < 0.021) by vasospasm after SAH and worse in patients with hydrocephalus in whom CSF circulation was normal (p < 0.02). In head injury, Mx indicated disturbed autoregulation with low CPP (< 55 mmHg) and too high CPP (> 95 mmHg). Mx strongly discriminated between patients with favourable and unfavourable outcome (p < 0.00002). This method can be used in many clinical scenarios for continuous monitoring of cerebral autoregulation, predicting outcome and optimising treatment strategies.
Mots-clé
Blood Flow Velocity, Blood Pressure, Carotid Stenosis/physiopathology, Case-Control Studies, Cerebrovascular Circulation, Craniocerebral Trauma/physiopathology, Homeostasis, Humans, Hydrocephalus/physiopathology, Middle Cerebral Artery/physiopathology, Middle Cerebral Artery/ultrasonography, Monitoring, Physiologic/methods, Subarachnoid Hemorrhage/physiopathology, Ultrasonography, Doppler, Transcranial
Pubmed
Création de la notice
29/12/2009 17:01
Dernière modification de la notice
20/08/2019 14:50
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