Cerebral autoregulation-oriented therapy at the bedside a comprehensive review

Lucia Rivera-Lara, Andres Zorrilla-Vaca, Romergryko G. Geocadin, Ryan J. Healy, Wendy Ziai, Marek A. Mirski

Research output: Contribution to journalReview articlepeer-review

Abstract

Tis comprehensive review summarizes the evidence regarding use of cerebral autoregulation-directed therapy at the bedside and provides an evaluation of its impact on optimizing cerebral perfusion and associated functional outcomes. Multiple studies in adults and several in children have shown the feasibility of individualizing mean arterial blood pressure and cerebral perfusion pressure goals by using cerebral autoregulation monitoring to calculate optimal levels. Nine of these studies examined the association between cerebral perfusion pressure or mean arterial blood pressure being above or below their optimal levels and functional outcomes. Six of these nine studies (66%) showed that patients for whom median cerebral perfusion pressure or mean arterial blood pressure differed signifcantly from the optimum, defned by cerebral autoregulation monitoring, were more likely to have an unfavorable outcome. Te evidence indicates that monitoring of continuous cerebral autoregulation at the bedside is feasible and has the potential to be used to direct blood pressure management in acutely ill patients.

Original languageEnglish (US)
Pages (from-to)1187-1199
Number of pages13
JournalAnesthesiology
Volume126
Issue number6
DOIs
StatePublished - 2017

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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