The upper limit of cerebral blood flow autoregulation is decreased with elevations in intracranial pressure

Matthew Pesek*, Kathleen Kibler, R. Blaine Easley, Jennifer Mytar, Christopher Rhee, Dean Andropolous, Kenneth Martin Brady

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: The upper limit of cerebrovascular pressure autoregulation (ULA) is inadequately characterized. We sought to delineate the ULA in a neonatal swine model. Methods: Neonatal piglets with sham surgery (n = 9), interventricular fluid infusion (INF; n = 10), controlled cortical impact (CCI; n = 10), or impact + infusion (CCI + INF; n = 11) had intracranial pressure monitoring and bilateral cortical laser-Doppler flux recordings during arterial hypertension until lethality. An increase in red cell flux as a function of cerebral perfusion pressure was determined by piecewise linear regression and static rates of autoregulation (SRoRs) were determined above and below this inflection. Results: When identified, the ULA (median [interquartile range]) was as follows: sham group: 102 mmHg (97–109), INF group: 75 mmHg (52–84), CCI group: 81 mmHg (69–101), and CCI + INF group: 61 mmHg (52–57; p = 0.01). Both groups with interventricular infusion had significantly lower ULA compared with the sham group. Conclusion: Neonatal piglets without intracranial pathological conditions tolerated acute hypertension, with minimal perturbation of cerebral blood flow. Piglets with acutely elevated intracranial pressure, with or without trauma, demonstrated loss of autoregulation when subjected to arterial hypertension.

Original languageEnglish (US)
Pages (from-to)229-231
Number of pages3
JournalActa Neurochirurgica, Supplementum
Volume122
DOIs
StatePublished - May 1 2016

Keywords

  • Cerebral perfusion pressure
  • Intracranial pressure
  • Upper limit of cerebrovascular pressure autoregulation

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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