Advertisement

 

 

Low spontaneous variability in cerebral blood flow velocity in non-survivors after cardiac arrest.

Low spontaneous variability in cerebral blood flow velocity in non-survivors after cardiac arrest.
Author Information (click to view)

van den Brule JM, Vinke EJ, van Loon LM, van der Hoeven JG, Hoedemaekers CW,


van den Brule JM, Vinke EJ, van Loon LM, van der Hoeven JG, Hoedemaekers CW, (click to view)

van den Brule JM, Vinke EJ, van Loon LM, van der Hoeven JG, Hoedemaekers CW,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Resuscitation 2016 12 19111() 110-115 pii S0300-9572(16)30582-2
Abstract
OBJECTIVE
To investigate spontaneous variability in the time and frequency domain in mean flow velocity (MFV) and mean arterial pressure (MAP) in comatose patients after cardiac arrest, and determine possible differences between survivors and non-survivors.

METHODS
A prospective observational study was performed at the ICU of a tertiary care university hospital in the Netherlands. We studied 11 comatose patients and 10 controls. MFV in the middle cerebral artery was measured with simultaneously recording of MAP. Coefficient of variation (CV) was used as a standardized measure of dispersion in the time domain. In the frequency domain, the average spectral power of MAP and MFV were calculated in the very low, low and high frequency bands.

RESULTS
In survivors CV of MFV increased from 4.66 [3.92-6.28] to 7.52 [5.52-15.23] % at T=72h. In non-survivors CV of MFV decreased from 9.02 [1.70-9.36] to 1.97 [1.97-1.97] %. CV of MAP was low immediately after admission (1.46 [1.09-2.25] %) and remained low at 72h (3.05 [1.87-3.63] %) (p=0.13). There were no differences in CV of MAP between survivors and non-survivors (p=0.30). We noticed significant differences between survivors and non-survivors in the VLF band for average spectral power of MAP (p=0.03) and MFV (p=0.003), whereby the power of both MAP and MFV increased in survivors during admission, while remaining low in non-survivors.

CONCLUSIONS
Cerebral blood flow is altered after cardiac arrest, with decreased spontaneous fluctuations in non-survivors. Most likely, these changes are the consequence of impaired intrinsic myogenic vascular function and autonomic dysregulation.

Submit a Comment

Your email address will not be published. Required fields are marked *

twenty − seventeen =

[ HIDE/SHOW ]