Monitoring of cerebral blood flow autoregulation in adults undergoing sevoflurane anesthesia: a prospective cohort study of two age groups.
Autoregulation of blood flow is a key feature of the human cerebral vascular system to assure adequate oxygenation and metabolism of the brain under changing physiological conditions. The impact of advanced age and anesthesia on cerebral autoregulation remains unclear. The primary objective of this...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 30; no. 3; pp. 255 - 265 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=115098866&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 115098866 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Jun2016 vid: 30 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 115098866 115098866 NLM26285741 115098866 10.1007/s10877-015-9754-z NLM26285741 115098866 ppf: 255 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Monitoring of cerebral blood flow autoregulation in adults undergoing sevoflurane anesthesia: a prospective cohort study of two age groups. aug: au: Goettel, Nicolai Patet, Camille Rossi, Ariane Burkhart, Christoph Czosnyka, Marek Strebel, Stephan Steiner, Luzius Burkhart, Christoph S Strebel, Stephan P Steiner, Luzius A affil: Department of Anesthesiology, Lausanne University Hospital, University of Lausanne, Lausanne Switzerland sug: subj: Cerebrovascular Circulation Physiology Anesthetics, Inhalation Administration and Dosage Ethers Administration and Dosage Blood Pressure Physiology Prospective Studies Adult Male Anesthetics, Inhalation Pharmacokinetics Blood Pressure Drug Effects Cerebrovascular Circulation Drug Effects Ethers Pharmacokinetics Aged Young Adult Homeostasis Drug Effects Adolescence Ultrasonography, Doppler, Transcranial Female Aged, 80 and Over Homeostasis Physiology Human Adult: 19-44 years Aged: 65+ years Adolescent: 13-18 years Aged, 80 & over Male Female ab: Autoregulation of blood flow is a key feature of the human cerebral vascular system to assure adequate oxygenation and metabolism of the brain under changing physiological conditions. The impact of advanced age and anesthesia on cerebral autoregulation remains unclear. The primary objective of this study was to determine the effect of sevoflurane anesthesia on cerebral autoregulation in two different age groups. This is a follow-up analysis of data acquired in a prospective observational cohort study. One hundred thirty-three patients aged 18-40 and ≥65 years scheduled for major noncardiac surgery under general anesthesia were included. Cerebral autoregulation indices, limits, and ranges were compared in young and elderly patient groups. Forty-nine patients (37 %) aged 18-40 years and 84 patients (63 %) aged ≥65 years were included in the study. Age-adjusted minimum alveolar concentrations of sevoflurane were 0.89 ± 0.07 in young and 0.99 ± 0.14 in older subjects (P < 0.001). Effective autoregulation was found in a blood pressure range of 13.8 ± 9.8 mmHg in young and 10.2 ± 8.6 mmHg in older patients (P = 0.079). The lower limit of autoregulation was 66 ± 12 mmHg and 73 ± 14 mmHg in young and older patients, respectively (P = 0.075). The association between sevoflurane concentrations and autoregulatory capacity was similar in both age groups. Our data suggests that the autoregulatory plateau is shortened in both young and older patients under sevoflurane anesthesia with approximately 1 MAC. Lower and upper limits of cerebral blood flow autoregulation, as well as the autoregulatory range, are not influenced by the age of anesthetized patients. Trial registration ClinicalTrials.gov (NCT00512200). pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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