Autoregulation in the Neuro ICU

Current Treatment Options in Neurology
Anson WangNils H Petersen

Abstract

The purpose of this review is to briefly describe the concept of cerebral autoregulation, to detail several bedside techniques for measuring and assessing autoregulation, and to outline the impact of impaired autoregulation on clinical and functional outcomes in acute brain injury. Furthermore, we will review several autoregulation studies in select forms of acute brain injuries, discuss the potential for its use in patient management in the ICU, and suggest further avenues for research. Cerebral autoregulation plays a critical role in regulating cerebral blood flow, and impaired autoregulation has been associated with worse functional and clinical outcomes in various acute brain injuries. There exists a multitude of methods to assess the autoregulatory state in patients using both invasive and non-invasive modalities. Continuous monitoring of patients in the ICU has yielded autoregulatory-derived optimal perfusion pressures that may prevent secondary injury and improve outcomes. Measuring autoregulation continuously at the bedside is now a feasible option for clinicians working in the ICU, although there exists a great need to standardize autoregulatory measurement. While the clinical benefits await prospective and randomized ...Continue Reading

References

Jan 1, 1989·Stroke; a Journal of Cerebral Circulation·R AaslidH Nornes
Nov 1, 1989·Journal of Applied Physiology·V K SomersF M Abboud
Jan 1, 1985·Journal of Neurosurgery·B VoldbyF T Jensen
Nov 1, 1981·Stroke; a Journal of Cerebral Circulation·J AstrupL Symon
Jun 1, 1995·Stroke; a Journal of Cerebral Circulation·F P TiecksD W Newell
May 1, 1994·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·J Hauerberg, M Juhler
Oct 1, 1996·Stroke; a Journal of Cerebral Circulation·M CzosnykaJ D Pickard
Mar 1, 1997·Stroke; a Journal of Cerebral Circulation·J W HopJ van Gijn
Jan 7, 1998·Journal of Neurology, Neurosurgery, and Psychiatry·M CzosnykaJ D Pickard
Apr 29, 1998·Journal of Neurosurgical Anesthesiology·J HauerbergM Juhler
Nov 13, 2001·Journal of Neurosurgery·M CzosnykaJ D Pickard
Apr 1, 1959·Physiological Reviews·N A LASSEN
Jan 30, 2004·Journal of Internal Medicine·K N VemmosM Mavrikakis
Mar 26, 2004·Anesthesia and Analgesia·Martin SoehlePeter J Kirkpatrick
Apr 1, 2005·British Journal of Neurosurgery·R B PaneraiD H Evans
Dec 13, 2006·The American Journal of Emergency Medicine·Adnan I QureshiAlluru S Reddi
Feb 10, 2007·Frontiers of Neurology and Neuroscience·Rune Aaslid
Mar 20, 2008·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Arenda Hea van BeekRené Wmm Jansen
Sep 23, 2008·Neurocritical Care·Luzius A SteinerMarek Czosnyka
Oct 7, 2008·Ultrasound in Medicine & Biology·Farzaneh A SorondLewis A Lipsitz
Jan 8, 2009·Neurocritical Care·Marek CzosnykaLuzius A Steiner
Nov 26, 2009·Neurosurgery·Mellanie V SpringerStephan A Mayer
Apr 21, 2010·Neurocritical Care·Philippe BijlengaPeter Smielewski
Jul 24, 2010·Stroke; a Journal of Cerebral Circulation·Christian ZweifelPeter Smielewski
Oct 12, 2010·Stroke; a Journal of Cerebral Circulation·Marcel J H AriesPatrick C A J Vroomen
Nov 12, 2010·Nature·David AttwellEric A Newman
Feb 11, 2012·Current Opinion in Critical Care·Erin M Grise, Opeolu Adeoye
May 24, 2012·Stroke; a Journal of Cerebral Circulation·Matthias JaegerJürgen Meixensberger

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Citations

Sep 10, 2019·Stroke; a Journal of Cerebral Circulation·Andrew SilvermanNils H Petersen
Aug 9, 2020·Frontiers in Neurology·Andrew SilvermanNils H Petersen
Oct 9, 2020·Case Reports in Neurological Medicine·Chamara DalugamaThilak Jayalath
Oct 8, 2021·Continuum : Lifelong Learning in Neurology·Eric M Liotta

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