scholarly journals 791: CEREBRAL PERFUSION REQUIRES ELEVATED MEAN ARTERIAL PRESSURE WITH IN SILICO MODEL OF SEPSIS

2021 ◽  
Vol 50 (1) ◽  
pp. 390-390
Author(s):  
Matthew Luchette ◽  
Kerri LaRovere ◽  
Cheuk Chung Au ◽  
Robert Tasker ◽  
Alireza Akhondi-Asl
2012 ◽  
Vol 112 (11) ◽  
pp. 1875-1883 ◽  
Author(s):  
Gilbert Moralez ◽  
Steven A. Romero ◽  
Caroline A. Rickards ◽  
Kathy L. Ryan ◽  
Victor A. Convertino ◽  
...  

We tested the hypothesis that dehydration exacerbates reductions of middle cerebral artery blood velocity (MCAv) and alters cerebrovascular control during standing after heavy resistance exercise. Ten males participated in two trials under 1) euhydration (EUH) and 2) dehydration (DEH; fluid restriction + 40 mg furosemide). We recorded finger photoplethysmographic arterial pressure and MCAv (transcranial Doppler) during 10 min of standing immediately after high-intensity leg press exercise. Symptoms (e.g., lightheadedness) were ranked by subjects during standing (1–5 scale). Low-frequency (LF) oscillations of mean arterial pressure (MAP) and mean MCAv were calculated as indicators of cerebrovascular control. DEH reduced plasma volume by 11% ( P = 0.002; calculated from hemoglobin and hematocrit). During the first 30 s of standing after exercise, subjects reported greater symptoms during DEH vs. EUH ( P = 0.05), but these were mild and resolved at 60 s. While MAP decreased similarly between conditions immediately after standing, MCAv decreased more with DEH than EUH ( P = 0.02). With prolonged standing under DEH, mean MCAv remained below baseline ( P ≤ 0.01), and below EUH values ( P ≤ 0.05). LF oscillations of MAP were higher for DEH at baseline and during the entire 10 min of stand after exercise ( P ≤ 0.057), while LF oscillations in mean MCAv were distinguishable only at baseline and 5 min following stand ( P = 0.05 ). Our results suggest that mean MCAv falls below a “symptomatic threshold” in the acute phase of standing after exercise during DEH, although symptoms were mild and transient. During the prolonged phase of standing, increases in LF MAP and mean MCAv oscillations with DEH may help to maintain cerebral perfusion despite absolute MCAv remaining below the symptomatic threshold.


Neurosurgery ◽  
1998 ◽  
Vol 43 (3) ◽  
pp. 714-714
Author(s):  
Sean D. Lavine ◽  
Michael L. Levy ◽  
Felipe Albuquerque ◽  
Vladimir Zelman ◽  
Steven L. Giannotta

2020 ◽  
Vol 16 (S3) ◽  
Author(s):  
Isabel J. Sible ◽  
Belinda Yew ◽  
Shubir Dutt ◽  
Yanrong Li ◽  
Jean K. Ho ◽  
...  

2021 ◽  
pp. 0271678X2110396
Author(s):  
Leonie Schumm ◽  
Coline L Lemale ◽  
Sebastian Major ◽  
Nils Hecht ◽  
Melina Nieminen-Kelhä ◽  
...  

Physiological effects of spreading depolarizations (SD) are only well studied in the first hours after experimental stroke. In patients with malignant hemispheric stroke (MHS), monitoring of SDs is restricted to the postoperative ICU stay, typically day 2-7 post-ictus. Therefore, we investigated the role of physiological variables (temperature, intracranial pressure, mean arterial pressure and cerebral perfusion pressure) in relationship to SD during the late phase after MHS in humans. Additionally, an experimental stroke model was used to investigate hemodynamic consequences of SD during this time window. In 60 patients with MHS, the occurrence of 1692 SDs was preceded by a decrease in mean arterial pressure (−1.04 mmHg; p = .02) and cerebral perfusion pressure (−1.04 mmHg; p = .03). Twenty-four hours after middle cerebral artery occlusion in 50 C57Bl6/J mice, hypothermia led to prolonged SD-induced hyperperfusion (+2.8 min; p < .05) whereas hypertension mitigated initial hypoperfusion (−1.4 min and +18.5%Δ rCBF; p < .01). MRI revealed that SDs elicited 24 hours after experimental stroke were associated with lesion progression (15.9 vs. 14.8 mm³; p < .01). These findings of small but significant effects of physiological variables on SDs in the late phase after ischemia support the hypothesis that the impact of SDs may be modified by adjusting physiological variables.


2017 ◽  
Author(s):  
C Reissfelder ◽  
T Mees ◽  
S Schölch ◽  
A Remer ◽  
A Seifert ◽  
...  

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