Low spontaneous variability in cerebral blood flow velocity in non-survivors after cardiac arrest

Brule, J.M.D. van den; Vinke, Elisabeth J.; Loon, Lex M. van; Hoeven, Johannes G. van der; Hoedemaekers, Cornelia

doi:10.1016/j.resuscitation.2016.12.005

Cited by 16 publications

(21 citation statements)

References 33 publications

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“…The hypoperfusion phase is due to an impairment of the metabolic/hemodynamic coupling mechanisms, and its severity is independent of the duration of ischaemia [ 14 ]. We confirmed this lack of a relationship between ischaemia duration and the severity of hypoperfusion in comatose patients after cardiac arrest (data not published) [ 15 ]. During the hypoperfusion phase, the CBF decreases by approximately 50% [ 16 , 17 ].…”

Section: Cerebral Blood Flow After Cardiac Arrestsupporting

confidence: 75%

Section: Cerebral Autoregulation Following Cardiac Arrestmentioning

confidence: 99%

“…In addition, immediately following cardiac arrest, spontaneous variability of MFV was found to be low [ 15 ]. MFV variability increased to normal values in patients who survived, whereas it further decreased in patients who did not survive after cardiac arrest [ 15 ]. It is plausible that these changes are the consequence of the associated severe brain damage, resulting in impaired control of intrinsic myogenic vascular function and autonomic dysregulation.…”

Section: Cerebral Autoregulation Following Cardiac Arrestmentioning

confidence: 99%

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Cerebral Perfusion and Cerebral Autoregulation after Cardiac Arrest

Brule

Hoeven

Hoedemaekers

2018

BioMed Research International

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Out of hospital cardiac arrest is the leading cause of death in industrialized countries. Recovery of hemodynamics does not necessarily lead to recovery of cerebral perfusion. The neurological injury induced by a circulatory arrest mainly determines the prognosis of patients after cardiac arrest and rates of survival with a favourable neurological outcome are low. This review focuses on the temporal course of cerebral perfusion and changes in cerebral autoregulation after out of hospital cardiac arrest. In the early phase after cardiac arrest, patients have a low cerebral blood flow that gradually restores towards normal values during the first 72 hours after cardiac arrest. Whether modification of the cerebral blood flow after return of spontaneous circulation impacts patient outcome remains to be determined.

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Section: Cerebral Blood Flow After Cardiac Arrestsupporting

confidence: 75%

Section: Cerebral Autoregulation Following Cardiac Arrestmentioning

confidence: 99%

Section: Cerebral Autoregulation Following Cardiac Arrestmentioning

confidence: 99%

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Cerebral Perfusion and Cerebral Autoregulation after Cardiac Arrest

Brule

Hoeven

Hoedemaekers

2018

BioMed Research International

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“…After cardiac arrest, the spontaneous variability of arterial pressure is significantly lower compared to age- and sex-matched control patients [ 11 ]. In addition, spontaneous variability in the mean flow velocity (MFV) in the middle cerebral artery as measured by transcranial Doppler (TCD) is also reduced.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, spontaneous variability in the mean flow velocity (MFV) in the middle cerebral artery as measured by transcranial Doppler (TCD) is also reduced. MFV variability restores towards normal values in survivors after cardiac arrest, while variability continues to decline in patients who do not survive [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Induced Blood Pressure Variability on the Assessment of Cerebral Autoregulation in Patients after Cardiac Arrest

Brule

Kaam

Hoeven

et al. 2018

BioMed Research International

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Objective To determine if increasing variability of blood pressure influences determination of cerebral autoregulation. Methods A prospective observational study was performed at the ICU of a university hospital in the Netherlands. 13 comatose patients after cardiac arrest underwent baseline and intervention (tilting of bed) measurements. Mean flow velocity (MFV) in the middle cerebral artery and mean arterial pressure (MAP) were measured. Coefficient of variation (CV) was used as a standardized measure of dispersion in the time domain. In the frequency domain, coherence, gain, and phase were calculated in the very low and low frequency bands. Results The CV of MAP was significantly higher during intervention compared to baseline. On individual level, coherence in the VLF band changed in 5 of 21 measurements from unreliable to reliable and in 6 of 21 measurements from reliable to unreliable. In the LF band 1 of 21 measurements changed from unreliable to reliable and 3 of 21 measurements from reliable to unreliable. Gain in the VLF and LF band was lower during intervention compared to baseline. Conclusions For the ICU setting, more attention should be paid to the exact experimental protocol, since changes in experimental settings strongly influence results of estimation of cerebral autoregulation.

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Emergency Department and Prehospital Brain US as Part of POCUS and US Multiorgan Evaluation

Via

Pétrovic

Rasulo

2020

Echography and Doppler of the Brain

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Low spontaneous variability in cerebral blood flow velocity in non-survivors after cardiac arrest

Abstract: Cerebral blood flow is altered after cardiac arrest, with decreased spontaneous fluctuations in non-survivors. Most likely, these changes are the consequence of impaired intrinsic myogenic vascular function and autonomic dysregulation.

Cited by 16 publications

References 33 publications

Cerebral Perfusion and Cerebral Autoregulation after Cardiac Arrest

Cerebral Perfusion and Cerebral Autoregulation after Cardiac Arrest

Influence of Induced Blood Pressure Variability on the Assessment of Cerebral Autoregulation in Patients after Cardiac Arrest

Emergency Department and Prehospital Brain US as Part of POCUS and US Multiorgan Evaluation

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