Chapter title |
The Upper Limit of Cerebral Blood Flow Autoregulation Is Decreased with Elevations in Intracranial Pressure.
|
---|---|
Chapter number | 46 |
Book title |
Intracranial Pressure and Brain Monitoring XV
|
Published in |
Acta neurochirurgica Supplement, January 2016
|
DOI | 10.1007/978-3-319-22533-3_46 |
Pubmed ID | |
Book ISBNs |
978-3-31-922532-6, 978-3-31-922533-3
|
Authors |
Matthew Pesek MD, Kathleen Kibler BS, R. Blaine Easley MD, Jennifer Mytar BS, Christopher Rhee MD, Dean Andropolous MD, Ken Brady MD, Matthew Pesek, Kathleen Kibler, R. Blaine Easley, Jennifer Mytar, Christopher Rhee, Dean Andropolous, Ken Brady |
Editors |
Beng-Ti Ang |
Abstract |
The upper limit of cerebrovascular pressure autoregulation (ULA) is inadequately characterized. We sought to delineate the ULA in a neonatal swine model. Neonatal piglets with sham surgery (n = 9), interventricular fluid infusion (INF; n = 10), controlled cortical impact (CCI; n = 10), or impact + infusion (CCI + INF; n = 11) had intracranial pressure monitoring and bilateral cortical laser-Doppler flux recordings during arterial hypertension until lethality. An increase in red cell flux as a function of cerebral perfusion pressure was determined by piecewise linear regression and static rates of autoregulation (SRoRs) were determined above and below this inflection. When identified, the ULA (median [interquartile range]) was as follows: sham group: 102 mmHg (97-109), INF group: 75 mmHg (52-84), CCI group: 81 mmHg (69-101), and CCI + INF group: 61 mmHg (52-57; p = 0.01). Both groups with interventricular infusion had significantly lower ULA compared with the sham group. Neonatal piglets without intracranial pathological conditions tolerated acute hypertension, with minimal perturbation of cerebral blood flow. Piglets with acutely elevated intracranial pressure, with or without trauma, demonstrated loss of autoregulation when subjected to arterial hypertension. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 17 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 3 | 18% |
Other | 2 | 12% |
Professor | 2 | 12% |
Student > Bachelor | 1 | 6% |
Student > Ph. D. Student | 1 | 6% |
Other | 1 | 6% |
Unknown | 7 | 41% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 4 | 24% |
Psychology | 2 | 12% |
Pharmacology, Toxicology and Pharmaceutical Science | 1 | 6% |
Mathematics | 1 | 6% |
Social Sciences | 1 | 6% |
Other | 1 | 6% |
Unknown | 7 | 41% |