scholarly journals Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Yaroslava Longhitano ◽  
Francesca Iannuzzi ◽  
Giulia Bonatti ◽  
Christian Zanza ◽  
Antonio Messina ◽  
...  
Keyword(s):  
Cerebral Autoregulation ◽  
Population Studies ◽  
Pediatric Population ◽  
Neurological Complications ◽  
Neurological Damage ◽  
Search Terms ◽  
Brain Injured ◽  
Sepsis And Septic Shock ◽  
Injured Patients

Introduction: Cerebral autoregulation (CA) plays a fundamental role in the maintenance of adequate cerebral blood flow (CBF). CA monitoring, through direct and indirect techniques, may guide an appropriate therapeutic approach aimed at improving CBF and reducing neurological complications; so far, the role of CA has been investigated mainly in brain-injured patients. The aim of this study is to investigate the role of CA in non-brain injured patients.Methods: A systematic consultation of literature was carried out. Search terms included: “CA and sepsis,” “CA and surgery,” and “CA and non-brain injury.”Results: Our research individualized 294 studies and after screening, 22 studies were analyzed in this study. Studies were divided in three groups: CA in sepsis and septic shock, CA during surgery, and CA in the pediatric population. Studies in sepsis and intraoperative setting highlighted a relationship between the incidence of sepsis-associated delirium and impaired CA. The most investigated setting in the pediatric population is cardiac surgery, but the role and measurement of CA need to be further elucidated.Conclusion: In non-brain injured patients, impaired CA may result in cognitive dysfunction, neurological damage, worst outcome, and increased mortality. Monitoring CA might be a useful tool for the bedside optimization and individualization of the clinical management in this group of patients.

scholarly journals The Expanding Role of Quantitative Pupillometry in the Evaluation and Management of Traumatic Brain Injury

2021 ◽  
Vol 12 ◽  
Author(s):  
Jason H. Boulter ◽  
Margaret M. Shields ◽  
Melissa R. Meister ◽  
Gregory Murtha ◽  
Brian P. Curry ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Ease Of Use ◽  
Brain Injured ◽  
The World ◽  
Injured Patients ◽  
Austere Environments ◽  
Active Investigation

Traumatic brain injury is a rapidly increasing source of morbidity and mortality across the world. As such, the evaluation and management of traumatic brain injuries ranging from mild to severe are under active investigation. Over the last two decades, quantitative pupillometry has been increasingly found to be useful in both the immediate evaluation and ongoing management of traumatic brain injured patients. Given these findings and the portability and ease of use of modern pupillometers, further adoption and deployment of quantitative pupillometers into the preclinical and hospital settings of both resource rich and medically austere environments.

A ROLE OF NUETROPHILS IN PULMONARY COMPLICATIONS DURING HYPOTHERMIC THERAPY FOR BRAIN-INJURED PATIENTS

Shock ◽  
2006 ◽  
Vol 25 (Supplement 1) ◽  
pp. 28
Author(s):  
T. Nishiyama ◽  
M. Aibiki ◽  
S. Maekawa ◽  
S. Ohtsubo ◽  
Y. Shirakawa
Keyword(s):  
Pulmonary Complications ◽  
Brain Injured ◽  
Injured Patients

scholarly journals Role of a successful spontaneous breathing trial in ventilator liberation in brain-injured patients

2021 ◽  
Vol 9 (7) ◽  
pp. 548-548
Author(s):  
Zhong-Hua Shi ◽  
Annemijn H. Jonkman ◽  
Pieter Roel Tuinman ◽  
Guang-Qiang Chen ◽  
Ming Xu ◽  
...  
Keyword(s):  
Spontaneous Breathing ◽  
Spontaneous Breathing Trial ◽  
Brain Injured ◽  
Injured Patients

scholarly journals Manajemen Tekanan Darah Setelah Cedera Sistem Saraf Pusat

2019 ◽  
Vol 8 (2) ◽  
pp. 132-43
Author(s):  
Radian Ahmad Halimi ◽  
Dewi Yulianti Bisri
Keyword(s):  
Blood Pressure ◽  
Brain Injury ◽  
Blood Pressure Reduction ◽  
Quality Data ◽  
Optimal Management ◽  
High Quality Data ◽  
Brain Injured ◽  
Considerable Controversy ◽  
Injured Patients

Hipertensi yang tidak terkontrol sering dijumpai setelah cedera otak. Mekanisme mengenai respon fisiologis dan patologis ini berhubungan dengan respons autoregulasi yang bertujuan untuk mempertahankan aliran darah otak di area yang terkena cedera. Respons hipertensi awal mungkin akan mempercepat/memicu cedera lebih lanjut. Sebaliknya, penurunan tekanan darah secara agresif justru berhubungan dengan kejadian iskemik. Meskipun tekanan darah sudah jelas berperan sebagai modulator dalam cedera otak akut, berbagai penelitian masih menunjukkan kontroversi dan belum ada data-data berkualitas terkait demografis, manajemen optimal terhadap tekanan darah tinggi dam hasil akhir pada pasien yang mengalami cedera otak akut. Deteksi kelainan autoregulasi yang terjadi setelah cedera otak dan kontrol tekanan darah secara hati-hati sangat dibutuhkan dalam manajemen optimal pasien tersebut. Blood Pressure Management After Central Nervous System InjuryAbstractUncontrolled hypertension is often encountered after brain injury. This mechanism related to physiologic and pathologic response are related to autoregulatory responses aimed at preserving the cerebral blood flow in injured areas. The initial hypertensive response may precipitate further injury. Conversely, aggresive blood pressure reduction may be associated with ischemia. Despite the clear role of blood pressure as a modulator of acute brain injury, there is considerable controversy and a lack of high-quality data regarding the demographics, outcomes, and optimal management of high blood pressure in acute brain-injured patients. Recognition of the autoregulatory abnormalities seen after brain injury and careful control of blood pressure are necessary for the optimal management of these patients.

Slow-to-Recover Brain-Injured Patients

1991 ◽  
Vol 34 (5) ◽  
pp. 1017-1022 ◽  
Author(s):  
Barbara J. Ansell
Keyword(s):  
Assessment Tool ◽  
Sensory Deprivation ◽  
Treatment Strategies ◽  
Sensory Stimulation ◽  
Neurological Damage ◽  
Reliable Assessment ◽  
Brain Injured ◽  
Enriched Environments ◽  
Injured Patients ◽  
Efficacy Of Treatment

Approximately 10–20% of head injury survivors sustain extensive neurological damage and remain minimally or inconsistently responsive to stimuli for 3–6 months postinjury. These patients, designated as slow to recover (STR), may be candidates for sensory stimulation programs rather than traditional rehabilitation. Medical and insurance personnel have resisted referral and payment for treatment because of the lack of objective measures of progress, a theoretical basis for treatment, and evidence of treatment efficacy. A valid, reliable assessment tool has recently been developed (Western Neuro Sensory Stimulation Profile) that assesses low-level cognitive/communicative function and documents improvement in STR patients. This article addresses the theoretical rationale for treatment. Evidence from four areas—sensory deprivation, enriched environments, nervous system plasticity, and sensitive periods of neurodevelopment— suggests that sensory stimulation programs are potentially beneficial for STR patients. Speech-language pathologists are encouraged to study the recovery patterns of STR patients and to determine the efficacy of treatment strategies.

Specific Computerized Attention Training in Stroke and Traumatic Brain-Injured Patients

2003 ◽  
Vol 14 (4) ◽  
pp. 283-292 ◽  
Author(s):  
W. Sturm ◽  
B. Fimm ◽  
A. Cantagallo ◽  
N. Cremel ◽  
P. North ◽  
...  
Keyword(s):  
Divided Attention ◽  
Single Case ◽  
Baseline Period ◽  
Specific Training ◽  
Attention Task ◽  
Baseline Phase ◽  
Computerized Training ◽  
Brain Injured ◽  
Divided Attention Task ◽  
Injured Patients

Abstract: In a multicenter European approach, the efficacy of the AIXTENT computerized training programs for intensity aspects (alertness and vigilance) and selectivity aspects (selective and divided attention) of attention was studied in 33 patients with brain damage of vascular and traumatic etiology. Each patient received training in one of two most impaired of the four attention domains. Control tests were performed by means of a standardized computerized attention test battery (TAP) comprising tests for the four attention functions. Assessment was carried out at the beginning and at the end of a four week baseline period and after the training period of 14 one-hour sessions. At the end of the baseline phase, there was only slight but significant improvement for the most complex attention function, divided attention (number of omissions). After the training, there were significant specific training effects for both intensity aspects (alertness and vigilance) and also for the number of omissions in the divided attention task. The application of inferential single case procedures revealed a high number of significant improvements in individual cases after specific training of alertness and vigilance problems. On the other hand, a non specific training addressing selectivity aspects of attention lead either to improvement or deterioration of alertness and vigilance performance. The results corroborate the findings of former studies with the same training instrument but in patients with different lesion etiologies.

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