Individualized perfusion targets in hypoxic ischemic brain injury after cardiac arrest

被引：0
作者：
Mypinder S. Sekhon
Donald E. Griesdale
机构：
[1] Vancouver General Hospital,Department of Medicine, Division of Critical Care Medicine
[2] Vancouver General Hospital,Department of Anesthesiology, Pharmacology and Therapeutics
[3] Centre for Clinical Epidemiology and Evaluation,Critical Care Medicine
[4] Vancouver Coastal Health Research Institute,undefined
[5] Vancouver General Hospital,undefined
来源：
Critical Care | / 21卷
关键词：
Hypoxemic ischemic brain injury; Cardiac arrest; Cerebral autoregulation; Mean arterial pressure; Cerebral oxygen delivery; Secondary injury;
D O I：
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学科分类号：
摘要：
Secondary injury is a major determinant of outcome in hypoxic ischemic brain injury (HIBI) after cardiac arrest and may be mitigated by optimizing cerebral oxygen delivery (CDO2). CDO2 is determined by cerebral blood flow (CBF), which is dependent upon mean arterial pressure (MAP). In health, CBF remains constant over the MAP range through cerebral autoregulation. In HIBI, the zone of intact cerebral autoregulation is narrowed and varies for each patient. Maintaining MAP within the intact autoregulation zone may mitigate ischemia, hyperemia and secondary injury. The optimal MAP in individual patients can be determined using real time autoregulation monitoring techniques.
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