Analysis of dynamic autoregulation assessed by the cuff deflation method.

Neurocritical Care
Roman HlatkyC S Robertson

Abstract

Dynamic testing of cerebral pressure autoregulation is more practical than static testing for critically ill patients. The process of cuff deflation is innocuous in the normal subject, but the systemic and cerebral effects of cuff deflation in severely head-injured patients have not been studied. The purposes of this study were to examine the physiological effects of cuff deflation and to study their impact on the calculation of autoregulatory index (ARI). In 24 severely head-injured patients, 388 thigh cuff deflations were analyzed. The physiological parameters were recorded before, during, and after a transient decrease in blood pressure. Autoregulation was graded by generating an ARI value from 0 to 9. Mean arterial blood pressure (MAP) dropped rapidly during the first 2-3 seconds, but the nadir MAP was not reached until 8 +/- 7 seconds after the cuff deflation. MAP decreased by an average value of 19 +/- 5 mmHg. Initially the tracings for MAP and cerebral perfusion pressure (CPP) were nearly identical, but after 30 seconds, variable increases in intracranial pressure caused some differences between the MAP and CPP curves. The difference between the ARI values calculated twice using MAP as well as CPP was zero for 70% of lef...Continue Reading

Citations

Nov 26, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Anthony A Figaji
Jan 8, 2009·Neurocritical Care·Marek CzosnykaLuzius A Steiner
Aug 6, 2010·Journal of Neurotrauma·Leonardo Rangel-CastillaClaudia Robertson
Feb 22, 2011·Journal of Neurotrauma·Claudia S RobertsonJ Clay Goodman
Aug 25, 2012·TheScientificWorldJournal·Andréa Soares de AraújoSathyabama Chellappa
Aug 18, 2010·Neurological Research·Leonardo Rangel-CastillaClaudia Robertson
Oct 15, 2014·PloS One·Max ChacónRonney B Panerai
Dec 13, 2017·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Ashwin B ParthasarathyMichael T Mullen
Sep 19, 2008·Physiological Measurement·M ChacónR B Panerai
Aug 4, 2020·Brain Injury : [BI]·Marcelo de-Lima-OliveiraEdson Bor-Seng-Shu

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