Monitoring of cerebral blood flow autoregulation in adults undergoing sevoflurane anesthesia: a prospective cohort study of two age groups.

Details

Serval ID
serval:BIB_DC57F39BD6C0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Monitoring of cerebral blood flow autoregulation in adults undergoing sevoflurane anesthesia: a prospective cohort study of two age groups.
Journal
Journal of clinical monitoring and computing
Author(s)
Goettel N., Patet C., Rossi A., Burkhart C.S., Czosnyka M., Strebel S.P., Steiner L.A.
ISSN
1573-2614 (Electronic)
ISSN-L
1387-1307
Publication state
Published
Issued date
06/2016
Peer-reviewed
Oui
Volume
30
Number
3
Pages
255-264
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
Autoregulation of blood flow is a key feature of the human cerebral vascular system to assure adequate oxygenation and metabolism of the brain under changing physiological conditions. The impact of advanced age and anesthesia on cerebral autoregulation remains unclear. The primary objective of this study was to determine the effect of sevoflurane anesthesia on cerebral autoregulation in two different age groups. This is a follow-up analysis of data acquired in a prospective observational cohort study. One hundred thirty-three patients aged 18-40 and ≥65 years scheduled for major noncardiac surgery under general anesthesia were included. Cerebral autoregulation indices, limits, and ranges were compared in young and elderly patient groups. Forty-nine patients (37 %) aged 18-40 years and 84 patients (63 %) aged ≥65 years were included in the study. Age-adjusted minimum alveolar concentrations of sevoflurane were 0.89 ± 0.07 in young and 0.99 ± 0.14 in older subjects (P < 0.001). Effective autoregulation was found in a blood pressure range of 13.8 ± 9.8 mmHg in young and 10.2 ± 8.6 mmHg in older patients (P = 0.079). The lower limit of autoregulation was 66 ± 12 mmHg and 73 ± 14 mmHg in young and older patients, respectively (P = 0.075). The association between sevoflurane concentrations and autoregulatory capacity was similar in both age groups. Our data suggests that the autoregulatory plateau is shortened in both young and older patients under sevoflurane anesthesia with approximately 1 MAC. Lower and upper limits of cerebral blood flow autoregulation, as well as the autoregulatory range, are not influenced by the age of anesthetized patients. Trial registration ClinicalTrials.gov (NCT00512200).

Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Anesthetics, Inhalation/administration & dosage, Anesthetics, Inhalation/pharmacokinetics, Blood Pressure/drug effects, Blood Pressure/physiology, Cerebrovascular Circulation/drug effects, Cerebrovascular Circulation/physiology, Cohort Studies, Female, Homeostasis/drug effects, Homeostasis/physiology, Humans, Male, Methyl Ethers/administration & dosage, Methyl Ethers/pharmacokinetics, Prospective Studies, Ultrasonography, Doppler, Transcranial, Young Adult
Pubmed
Create date
03/06/2016 18:22
Last modification date
20/08/2019 17:01
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