scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Augmentation Index ◽  
Applanation Tonometry ◽  
Co2 Reactivity ◽  
Anesthetic Induction ◽  
Entire Study ◽  
Circulatory Effects ◽  
Cerebral Vasoreactivity

Abstract Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation index as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. Doppler Trial Registration: The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered. Date of registration: February 4, 2014.

scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Applanation Tonometry ◽  
Co2 Reactivity ◽  
Anesthetic Induction ◽  
Hemodynamic Changes ◽  
Entire Study ◽  
Circulatory Effects ◽  
Cerebral Vasoreactivity

Abstract Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation idex as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered.

scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Transcranial Doppler ◽  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Applanation Tonometry ◽  
Co2 Reactivity ◽  
Anesthetic Induction ◽  
Key Words Sevoflurane ◽  
Entire Study ◽  
Circulatory Effects

Abstract Background: Sevoflurane is one of the most frequently used inhaled anesthetics for general anesthesia. Previously it has been reported that at clinically used doses of sevoflurane, cerebral vasoreactivity is maintained. However, there are no data how sevoflurane influences systemic and cerebral circulation in parallel. The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during sevoflurane anesthesia. Methods: 29 patients undergoing general anesthesia were enrolled. Anesthesia was maintained with 1 MAC sevoflurane in 40% oxygen. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5 minutes respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results: Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure and augmentation idex as markers of arterial stiffness significantly increased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained at 1 MAC sevoflurane. Discussion: Cerebral autoregulation and CO2-reactivity is preserved at 1 MAC sevoflurane. Cerebrovascular effects of anesthetic compounds have to be assessed together with systemic circulatory effects. Key words: sevoflurane; cerebral blood flow, cerebral autoregulation; CO2-reactivity, applanation tonometry; transcranial Doppler The study was registered at http://www.clinicaltrials.gov, identifier: NCT02054143, retrospectively registered.

scholarly journals Effect of sevoflurane on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marianna Juhász ◽  
Levente Molnár ◽  
Béla Fülesdi ◽  
Tamás Végh ◽  
Dénes Páll ◽  
...  
Keyword(s):  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Co2 Reactivity

scholarly journals Impact of hypertension severity on arterial stiffness, cerebral vasoreactivity, and cognitive performance

2017 ◽  
Vol 11 (4) ◽  
pp. 389-397 ◽  
Author(s):  
Henrique Cotchi Simbo Muela ◽  
Valeria A. Costa-Hong ◽  
Monica Sanches Yassuda ◽  
Michel Ferreira Machado ◽  
Ricardo de Carvalho Nogueira ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Arterial Stiffness ◽  
Cognitive Performance ◽  
Augmentation Index ◽  
Applanation Tonometry ◽  
Breath Holding ◽  
Functional Changes ◽  
Stage 1 ◽  
Artery Flow ◽  
Cerebral Vasoreactivity

ABSTRACT. Aging, hypertension (HTN), and other cardiovascular risk factors contribute to structural and functional changes of the arterial wall. Objective: To evaluate whether arterial stiffness (AS) is related to cerebral blood flow changes and its association with cognitive function in patients with hypertension. Methods: 211 patients (69 normotensive and 142 hypertensive) were included. Patients with hypertension were divided into 2 stages: HTN stage-1 and HTN stage-2. The mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA) and a battery of neuropsychological (NPE) tests were used to determine cognitive function. Pulse wave velocity was measured using the Complior®. Carotid properties were assessed by radiofrequency ultrasound. Central arterial pressure and augmentation index were obtained using applanation tonometry. Middle cerebral artery flow velocity was measured by transcranial Doppler ultrasonography. Results: Both arterial stiffness parameters and cerebral vasoreactivity worsened in line with HTN severity. There was a negative correlation between breath holding index (BHI) and arterial stiffness parameters. Cognitive performance worsened in line with HTN severity, with statistical difference occurring mainly between the HTN-2 and normotension groups on both the MMSE and MoCA. The same tendency was observed on the NPE tests. Conclusion: Hypertension severity was associated with higher AS, worse BHI, and lower cognitive performance.

Cerebral Autoregulation and CO2 Reactivity in Anterior and Posterior Cerebral Circulation During Sevoflurane Anesthesia

2006 ◽  
Vol 102 (2) ◽  
pp. 560-564 ◽  
Author(s):  
Irene Rozet ◽  
Monica S. Vavilala ◽  
Andrew M. Lindley ◽  
Elizabeth Visco ◽  
Miriam Treggiari ◽  
...  
Keyword(s):  
Cerebral Circulation ◽  
Cerebral Autoregulation ◽  
Sevoflurane Anesthesia ◽  
Co2 Reactivity ◽  
Posterior Cerebral Circulation

Applanation Tonometry for Assessment of Left Ventricular Systolic Load

2019 ◽  
Vol 12 (2) ◽  
pp. 94-99
Author(s):  
Rene D. Mileva-Popova ◽  
Nina Y. Belova
Keyword(s):  
Arterial Stiffness ◽  
Augmentation Index ◽  
Age Groups ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Applanation Tonometry ◽  
Non Invasive ◽  
Pressure Area ◽  
Older Subjects ◽  
And Gender

Summary Vascular-ventricular coupling is a major determinant of left ventricular load. The aim of our study was to assess non- invasively left ventricular load and its dependency on central hemodynamics. Sixty-five healthy and gender-matched individuals were divided in two groups according to their age: 20y/o and 50y/o. Applanation tonometry was performed using the Sphygmocor device. Central pressures and pulse wave analysis indices were computed. Central systolic (120±3 vs. 98±2 mm Hg) and pulse pressures (43±3 vs. 29±1 mm Hg) as well as the augmentation index (AIx75) (23±3 vs. 6±2%) were significantly higher in the 50y/o group (p<0.01). These parameters are relevant markers of arterial stiffness and evidenced the development of central arterial morphological and functional alterations in the older subjects. The time-tension index (TTI) computed from the systolic pressure area was significantly higher in the 50y/o subjects as compared to the 20y/o group (2378±66 vs. 1954±73 mmHg×s, p<0.01). Moreover, we have shown the presence of significant correlation between TTI and AIx75 (p<0.01) in both age groups. This finding confirmed the contribution of arterial stiffness for the impaired vascular-ventricular coupling. In conclusion, applanation tonometry might be utilized for non-invasive evaluation of the left ventricular load, which is an important parameter of cardiovascular risk.

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