Reduced cerebral vasomotor reactivity as an indicator of postoperative confusion

Anaesthesia
C KesslerK von Ackeren

Abstract

Surgical intervention in elderly patients carries a high risk. A frequent problem with surgery in these patients is the occurrence of a temporary confusional state, which increases both the risk of postoperative complications and the need for intensive care. We hypothesised that, in part, temporary confusional state results from cerebral hypoxia occurring in response to blood pressure fluctuations during surgery. To assess whether disruption of autoregulation of cerebral blood vessels plays a role in temporary confusional state, we studied 31 patients over 55 years of age, using the Doppler-carbon dioxide test. We determined whether vasomotor reactivity could be used diagnostically to identify those patients most likely to experience temporary confusional state. Blood flow velocity in the middle cerebral artery was detected using Doppler ultrasound, and hypercapnia was induced by breathing carbon dioxide until an end-tidal concentration of 8.0% by volume was reached. Vasomotor reactivity was calculated on the basis of the changes in blood flow velocity in response to the increase in carbon dioxide. Temporary confusional state was assessed using the Syndrome Short Test (Syndrom-Kurztest). We found that resting blood flow velocit...Continue Reading

Citations

Aug 6, 2008·Fiziologiia cheloveka·N A AgadzhanianO M Ruseĭkina
Feb 21, 2002·Journal of Vascular Surgery·Scott F RosenKenneth E McIntyre
Sep 10, 2004·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Ellen E OlsonRobert J McKeon

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