Neonatal cerebrovascular autoregulation

Christopher J. Rhee, Cristine Sortica da Costa, Topun Austin, Ken M. Brady, Marek Czosnyka, Jennifer Lee-Summers

Research output: Contribution to journalArticle

Abstract

Cerebrovascular pressure autoregulation is the physiologic mechanism that holds cerebral blood flow (CBF) relatively constant across changes in cerebral perfusion pressure (CPP). Cerebral vasoreactivity refers to the vasoconstriction and vasodilation that occur during fluctuations in arterial blood pressure (ABP) to maintain autoregulation. These are vital protective mechanisms of the brain. Impairments in pressure autoregulation increase the risk of brain injury and persistent neurologic disability. Autoregulation may be impaired during various neonatal disease states including prematurity, hypoxic–ischemic encephalopathy (HIE), intraventricular hemorrhage, congenital cardiac disease, and infants requiring extracorporeal membrane oxygenation (ECMO). Because infants are exquisitely sensitive to changes in cerebral blood flow (CBF), both hypoperfusion and hyperperfusion can cause significant neurologic injury. We will review neonatal pressure autoregulation and autoregulation monitoring techniques with a focus on brain protection. Current clinical therapies have failed to fully prevent permanent brain injuries in neonates. Adjuvant treatments that support and optimize autoregulation may improve neurologic outcomes.

Original languageEnglish (US)
JournalPediatric Research
DOIs
StateAccepted/In press - Jan 1 2018

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Homeostasis
Cerebrovascular Circulation
Pressure
Brain Injuries
Nervous System
Infant, Newborn, Diseases
Nervous System Trauma
Extracorporeal Membrane Oxygenation
Brain
Brain Diseases
Vasoconstriction
Vasodilation
Heart Diseases
Arterial Pressure
Newborn Infant
Hemorrhage
Therapeutics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Rhee, C. J., da Costa, C. S., Austin, T., Brady, K. M., Czosnyka, M., & Lee-Summers, J. (Accepted/In press). Neonatal cerebrovascular autoregulation. Pediatric Research. https://doi.org/10.1038/s41390-018-0141-6

Neonatal cerebrovascular autoregulation. / Rhee, Christopher J.; da Costa, Cristine Sortica; Austin, Topun; Brady, Ken M.; Czosnyka, Marek; Lee-Summers, Jennifer.

In: Pediatric Research, 01.01.2018.

Research output: Contribution to journalArticle

Rhee, Christopher J. ; da Costa, Cristine Sortica ; Austin, Topun ; Brady, Ken M. ; Czosnyka, Marek ; Lee-Summers, Jennifer. / Neonatal cerebrovascular autoregulation. In: Pediatric Research. 2018.
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