Assessment of dynamic cerebral autoregulation and cerebral carbon dioxide reactivity during normothermic cardiopulmonary bypass

Autor: Werner H. Mess, Jos G. Maessen, Erik D. Gommer, Patrick W. Weerwind, Jos P. H. Reulen, Ervin E. Severdija
Přispěvatelé: MUMC+: HZC Niet Med Staf Klinische Neurofys (9), MUMC+: MA Extra Corp Circ CTC (9), Klinische Neurowetenschappen, MUMC+: HZC Klinische Neurofysiologie (5), MUMC+: MA Cardiothoracale Chirurgie (3), CTC, RS: CARIM - R2 - Cardiac function and failure, RS: CARIM - R3 - Vascular biology
Rok vydání: 2014
Předmět:
Zdroj: Medical & Biological Engineering & Computing, 53(3), 195-203. Springer
ISSN: 1741-0444
0140-0118
DOI: 10.1007/s11517-014-1225-z
Popis: Despite increased risk of neurological complications after cardiac surgery, monitoring of cerebral hemodynamics during cardiopulmonary bypass (CPB) is still not a common practice. Therefore, a technique to evaluate dynamic cerebral autoregulation and cerebral carbon dioxide reactivity (CO2R) during normothermic nonpulsatile CPB is presented. The technique uses continuous recording of invasive arterial blood pressure, middle cerebral artery blood flow velocity, absolute cerebral tissue oxygenation, in-line arterial carbon dioxide levels, and pump flow measurement in 37 adult male patients undergoing elective CPB. Cerebral autoregulation is estimated by transfer function analysis and the autoregulation index, based on the response to blood pressure variation induced by cyclic 6/min changes of indexed pump flow from 2.0 to 2.4 up to 2.8 L/min/m(2). CO2R was calculated from recordings of both cerebral blood flow velocity and cerebral tissue oxygenation. Cerebral autoregulation and CO2R were estimated at hypocapnia, normocapnia, and hypercapnia. CO2R was preserved during CPB, but significantly lower for hypocapnia compared with hypercapnia (p
Databáze: OpenAIRE
Externí odkaz: