The Upper Limit of Cerebral Blood Flow Autoregulation Is Decreased with Elevations in Intracranial Pressure.
Acta Neurochir Suppl
; 122: 229-31, 2016.
Article
em En
| MEDLINE
| ID: mdl-27165912
ABSTRACT
BACKGROUND:
The upper limit of cerebrovascular pressure autoregulation (ULA) is inadequately characterized. We sought to delineate the ULA in a neonatal swine model.METHODS:
Neonatal piglets with sham surgery (n = 9), interventricular fluid infusion (INF; n = 10), controlled cortical impact (CCI; n = 10), or impact + infusion (CCI + INF; n = 11) had intracranial pressure monitoring and bilateral cortical laser-Doppler flux recordings during arterial hypertension until lethality. An increase in red cell flux as a function of cerebral perfusion pressure was determined by piecewise linear regression and static rates of autoregulation (SRoRs) were determined above and below this inflection.RESULTS:
When identified, the ULA (median [interquartile range]) was as follows sham group 102 mmHg (97-109), INF group 75 mmHg (52-84), CCI group 81 mmHg (69-101), and CCI + INF group 61 mmHg (52-57; p = 0.01). Both groups with interventricular infusion had significantly lower ULA compared with the sham group.CONCLUSION:
Neonatal piglets without intracranial pathological conditions tolerated acute hypertension, with minimal perturbation of cerebral blood flow. Piglets with acutely elevated intracranial pressure, with or without trauma, demonstrated loss of autoregulation when subjected to arterial hypertension.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Circulação Cerebrovascular
/
Hipertensão Intracraniana
/
Lesões Encefálicas Traumáticas
/
Homeostase
Tipo de estudo:
Etiology_studies
Limite:
Animals
Idioma:
En
Revista:
Acta Neurochir Suppl
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Estados Unidos