Critical Closing Pressure During a Controlled Increase in Intracranial Pressure

2018 ◽  
pp. 133-137
Author(s):  
Katarzyna Kaczmarska ◽  
Magdalena Kasprowicz ◽  
Antoni Grzanka ◽  
Wojciech Zabołotny ◽  
Peter Smielewski ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Critical Closing Pressure ◽  
Closing Pressure

Experimental cerebral hemodynamics

1974 ◽  
Vol 41 (5) ◽  
pp. 597-606 ◽  
Author(s):  
Richard C. Dewey ◽  
Heinz P. Pieper ◽  
William E. Hunt
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Mean Arterial Pressure ◽  
Intracranial Pressure ◽  
Perfusion Pressure ◽  
Brain Blood Flow ◽  
Vasomotor Tone ◽  
Vascular Bed ◽  
Critical Closing Pressure ◽  
Closing Pressure

✓ Application of Burton's concept of the critical closing pressure to experimental data on brain-blood flow in the monkey suggests that perfusion pressure, not vascular bed resistance, is the primary variable affecting cerebral blood flow. Perfusion pressure for the cerebral circulation is the mean arterial pressure minus the critical closing pressure (MAP — CCP). Vasomotor tone and intracranial pressure are the major determinants of the critical closing pressure. Changes in either of these variables, therefore, affect perfusion pressure and flow. Data on brain-blood flow at fixed vasomotor tone obtained over wide pressure ranges show little change in vascular bed resistance despite significant changes in flow. The diameter of resistance vessels probably does not change significantly throughout the normal physiological range of cerebral blood flow. The limits of the critical closing pressure in the anesthetized monkey are from 10 to 95 mm Hg. Using these limits, and beginning with the average values for MAP and CCP in 11 awake monkeys breathing room air, the authors present theoretical flow curves in response to changes in intracranial pressure and mean arterial pressure that closely approximate the data reported in man.

Critical Closing Pressure During Intracranial Pressure Plateau Waves

2013 ◽  
Vol 18 (3) ◽  
pp. 341-348 ◽  
Author(s):  
Georgios V. Varsos ◽  
Nicolás de Riva ◽  
Peter Smielewski ◽  
John D. Pickard ◽  
Ken M. Brady ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Plateau Waves ◽  
Critical Closing Pressure ◽  
Closing Pressure ◽  
Pressure Plateau

Relationship between Intracranial Pressure and Critical Closing Pressure in Patients with Neurotrauma

2002 ◽  
Vol 96 (3) ◽  
pp. 595-599 ◽  
Author(s):  
Christof Thees ◽  
Martin Scholz ◽  
Carlo Schaller ◽  
Annette Gass ◽  
Christos Pavlidis ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Cerebral Perfusion Pressure ◽  
Linear Correlation ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Trauma Patients ◽  
Critical Closing Pressure ◽  
The Difference ◽  
Closing Pressure ◽  
Zero Flow

Background The driving pressure gradient for cerebral perfusion is the difference between mean arterial pressure (MAP) and critical closing pressure (CCP = zero flow pressure). Therefore, determination of the difference between MAP and CCP should provide an appropriate monitoring of the effective cerebral perfusion pressure (CPP(eff)). Based on this concept, the authors compared conventional measurements of cerebral perfusion pressure by MAP and intracranial pressure (CPP(ICP)) with CPP(eff). Methods Simultaneous synchronized recordings of pressure waveforms of the radial artery and blood flow velocities of the middle cerebral artery were performed in 70 head trauma patients. CCP was calculated from pressure-flow velocity plots by linear extrapolation to zero flow. Results Intracranial pressure measured by intraventricular probes and CCP ranged from 3 to 71 and 4 to 70 mmHg, respectively. Linear correlation between ICP and CCP was r = 0.91. CPP(ICP) was 77 +/- 20 mmHg and did not differ from CPP(eff); linear correlation was r = 0.92. However, limits of agreement were only +/- 16.2 mmHg. Therefore, in 51.4% of the patients, CPP(ICP) overestimated CPP(eff) by 19.8 mmHg at most. Conclusion Assuming that CPP(eff) (MAP - CCP) takes into account more determinants of cerebral downstream pressure, in individual cases, the actual gold standard of CPP determination (MAP - ICP) might overestimate the CPP(eff) of therapeutic significance.

Critical Closing Pressure During Controlled Increase in Intracranial Pressure—Comparison of Three Methods

2018 ◽  
Vol 65 (3) ◽  
pp. 619-624 ◽  
Author(s):  
Katarzyna Kaczmarska ◽  
Magdalena Kasprowicz ◽  
Agnieszka Uryga ◽  
Leanne Calviello ◽  
Georgios Varsos ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Critical Closing Pressure ◽  
Closing Pressure

A square-pulse flow method for measuring characteristics of the arterial bed

1976 ◽  
Vol 40 (3) ◽  
pp. 425-433 ◽  
Author(s):  
M. G. Bottomley ◽  
G. W. Mainwood
Keyword(s):  
Arterial Compliance ◽  
Peripheral Resistance ◽  
Mean Value ◽  
Pressure Response ◽  
Arterial System ◽  
Response Curves ◽  
Arterial Tree ◽  
Pulse Flow ◽  
Critical Closing Pressure ◽  
Closing Pressure

A device was designed to provide a “square” pulse of blood flow into the arterial system. Pulses were injected into the carotid artery of the rabbit during transient cardiac arrest. Analysis of pressure response curves generated by the flow provides information as to the state of the arterial tree. With certain assumptions it is possible to estimate from these curves lumped values of peripheral resistance, critical closing pressure, and arterial compliance. In a series of 12 rabbits the mean value of peripheral resistance was found to be 0.21 +/- 0.7 mmHg-ml-1-min and critical closing pressure was estimated to be 23.6 +/- 3.8 mmHg. This method gives two possible values for arterial compliance 0.036 +/- 0.010 and 0.055 +/- 0.010 ml-mm-1 based, respectively, on the rise and decay curves of the pressure response. The theory and limitations of the method are discussed. The use of the method is illustrated in following the response to increased PCO2 and hemorrhage.

Cerebral Critical Closing Pressure During Infusion Tests

2016 ◽  
pp. 215-220 ◽  
Author(s):  
Georgios V. Varsos ◽  
Marek Czosnyka ◽  
Peter Smielewski ◽  
Matthew R. Garnett ◽  
Xiuyun Liu ◽  
...  
Keyword(s):  
Critical Closing Pressure ◽  
Closing Pressure

Asystolic Gradient, Intrinsic Blood Pressure and Critical Closing Pressure in the Human Forearm

1956 ◽  
Vol 9 (1) ◽  
pp. 69-74 ◽  
Author(s):  
A. Lanari ◽  
B. Bromberger-Barnea ◽  
E. Attinger
Keyword(s):  
Blood Pressure ◽  
Critical Closing Pressure ◽  
Human Forearm ◽  
Closing Pressure
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