Chapter title |
The Ontogeny of Cerebrovascular Critical Closing Pressure.
|
---|---|
Chapter number | 50 |
Book title |
Intracranial Pressure and Brain Monitoring XV
|
Published in |
Acta neurochirurgica Supplement, January 2016
|
DOI | 10.1007/978-3-319-22533-3_50 |
Pubmed ID | |
Book ISBNs |
978-3-31-922532-6, 978-3-31-922533-3
|
Authors |
Rhee, Christopher J, Fraser, Charles D, Kibler, Kathleen, Easley, Ronald B, Andropoulos, Dean B, Czosnyka, Marek, Varsos, Georgios V, Smielewski, Peter, Rusin, Craig G, Brady, Ken M, Kaiser, Jeffrey R, Christopher J. Rhee MD, Charles D. Fraser III, Kathleen Kibler BS, Ronald B. Easley MD, Dean B. Andropoulos MD, Marek Czosnyka PhD, Georgios V. Varsos MSc, PhD, Peter Smielewski PhD, Craig G. Rusin PhD, Ken M. Brady MD, Jeffrey R. Kaiser MD, MA, Rhee, Christopher J., Fraser, Charles D., Easley, Ronald B., Andropoulos, Dean B., Varsos, Georgios V., Rusin, Craig G., Brady, Ken M., Kaiser, Jeffrey R., Christopher J. Rhee, Charles D. FraserIII, Kathleen Kibler, Ronald B. Easley, Dean B. Andropoulos, Marek Czosnyka, Georgios V. Varsos, Peter Smielewski, Craig G. Rusin, Ken M. Brady, Jeffrey R. Kaiser, Charles D. Fraser |
Editors |
Beng-Ti Ang |
Abstract |
Premature infants are at risk of vascular neurological insults. Hypotension and hypertension are considered injurious, but neither condition is defined with consensus. Critical closing pressure (CrCP) is the arterial blood pressure (ABP) at which cerebral blood flow ceases. CrCP may serve to define subject-specific low or high ABP. Our objective was to quantify CrCP as a function of gestational age (GA). One hundred eighty-six premature infants with a GA range of 23-33 weeks, were monitored with umbilical artery catheters and transcranial Doppler insonation of middle cerebral artery flow velocity (FV) for 1-h sessions over the first week of life. CrCP was calculated using an impedance model derivation with Doppler-based estimations of cerebrovascular resistance and compliance. CrCP increased significantly with GA (r = 0.47; slope = 1.4 mmHg/week gestation), an association that persisted with multivariate analysis (p < 0.001). Higher diastolic ABP and higher GA were associated with increased CrCP (p <0.001 for both). CrCP increases significantly at the end of the second and beginning of the third trimester. The low CrCP observed in premature infants may explain their ability to tolerate low ABP without global cerebral infarct or hemorrhage. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 21 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 3 | 14% |
Professor > Associate Professor | 3 | 14% |
Student > Ph. D. Student | 3 | 14% |
Student > Doctoral Student | 2 | 10% |
Student > Bachelor | 2 | 10% |
Other | 6 | 29% |
Unknown | 2 | 10% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 10 | 48% |
Engineering | 2 | 10% |
Agricultural and Biological Sciences | 1 | 5% |
Computer Science | 1 | 5% |
Social Sciences | 1 | 5% |
Other | 3 | 14% |
Unknown | 3 | 14% |