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Cerebral Autoregulation in Unconscious Patients with Brain Injury
Author(s) -
Cold Georg Emil,
Jensen Finn Taagehøj
Publication year - 1978
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1978.tb01301.x
Subject(s) - autoregulation , medicine , cerebral autoregulation , cerebral blood flow , cerebral perfusion pressure , anesthesia , blood pressure , perfusion , intracranial pressure , cardiology
In 18 unconscious patients with traumatic brain injury, the cerebral autoregulation was tested during the first 2–3 weeks after the acute trauma. Regional cerebral blood flow (rCBF) was measured by the intra‐arterial 133 xenon washout method before and after an increase of about 20% in the mean arterial blood pressure (MABP) by angiotensin. The difference between MABP and intraventricular pressure (IVP) was used as cerebral perfusion pressure (PP). Simultaneously, ventricular fluid pH, lactate and pyruvate were measured. Regional loss of autoregulation indicated by a 20% flow increase was observed in 29 out of 35 studies (83%), while hemispheric loss of autoregulation was observed in only one study. The results of the autoregulation tests were unrelated to the clinical outcome, the presence of brain‐stem lesion, and the ventricular fluid pH, lactate and lactate/pyruvate ratio. In repeated studies, a gradual normalization of the autoregulation was observed about 5 days after the acute trauma.