Transient changes in brain tissue oxygen in response to modifications of cerebral perfusion pressure: an observational study.

Anesthesia and Analgesia
Danila K RadolovichPeter Smielewski

Abstract

The relative merits of the mechanisms for the maintenance of brain tissue oxygenation (PbtO(2)) have been much debated. There is a wealth of studies regarding various factors that may determine the absolute value and changes in PbtO(2). However, only a few of them analyzed fast (few minutes) and transient behavior of PbtO(2) in response to variations (waves) of intracranial pressure (ICP) and cerebral perfusion pressure (CPP). This was a retrospective analysis and observational study. PbtO(2), arterial blood pressure (ABP), and ICP waveforms were digitally monitored in 23 head-injured patients, admitted to the Neuroscience Critical Care Unit, who were sedated, paralyzed, and ventilated. Computer recordings were retrospectively reviewed. The dynamic changes in PbtO(2) in response to transient changes in ABP and ICP were investigated. Several patterns of response to short-lasting arterial hypotension and hypertension, intracranial hypertension, cerebral vasocycling, and cerebral hyperemia were observed and characterized. During the majority of the transient events, PbtO(2) generally followed the direction of changes in CPP. Only during episodes of hyperemia, CPP and PbtO(2) changed in the opposite direction. Changes in PbtO(2) we...Continue Reading

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Citations

Mar 12, 2011·Neurocritical Care·Leif-Erik BohmanMichael F Stiefel
Sep 28, 2013·Neurocritical Care·Celeste DiasMarek Czosnyka
Sep 12, 2014·Neurocritical Care·Mauro OddoUNKNOWN Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring
Aug 16, 2016·Anesthesiology Clinics·Matthew A Kirkman, Martin Smith
Apr 9, 2014·Journal of Intensive Care Medicine·Michael A De Georgia
Feb 20, 2013·Nature Reviews. Neurology·Karol P BudohoskiJohn D Pickard
Jan 23, 2021·Resuscitation·Markus Harboe OlsenKirsten Møller
May 1, 2021·Journal of Clinical Medicine·Afroditi Despina LalouZofia Czosnyka

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