Dynamic cerebral autoregulation in healthy adolescents

Background: There is little information on the limits of cerebral autoregulation and the autoregulatory capacity in children. The aim of this study was to compare dynamic cerebral autoregulation between healthy adolescents and adults. Methods: Seventeen healthy volunteers 12-17 years (n = 8) and 25-45 years (n = 9) were enrolled in this study. Bilateral mean middle cerebral artery flow velocities (Vmca; (cm/s)) were measured using transcranial Doppler ultrasonography (TCD). Mean arterial blood pressure (MAP) and end-tidal carbon dioxide were measured continuously during dynamic cerebral autoregulation studies. Blood pressure cuffs were placed around both thighs and inflated to 30 mmHg above the systolic blood pressure for 3 min and then rapidly deflated, resulting in transient systemic hypotension. The change of Vmca to change in MAP constitutes the autoregulatory response, and the speed of this response was quantified using computer model parameter estimation. The dynamic autoregulatory index (ARI) was averaged between the two sides. Results: Adolescents had significantly lower ARI (3.9+/-2.1 vs. 5.3+/-0.8; P=0.0), and higher Vmca (75.2+/-15.2 vs. 57.6+/-15.0; P<0.001) than adults. Conclusion: The autoregulatory index is physiologically lower in normal adolescents 12-17years of age than in adults. (C) Acta Anaesthesiologica Scandinavica 46 (2002).