Autoregulation in the Neuro ICU

  • Anson Wang
  • Santiago Ortega-Gutierrez
  • Nils H. PetersenEmail author
Critical Care Neurology (KN Sheth, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Critical Care Neurology


Purpose of review

The purpose of this review is to briefly describe the concept of cerebral autoregulation, to detail several bedside techniques for measuring and assessing autoregulation, and to outline the impact of impaired autoregulation on clinical and functional outcomes in acute brain injury. Furthermore, we will review several autoregulation studies in select forms of acute brain injuries, discuss the potential for its use in patient management in the ICU, and suggest further avenues for research.

Recent findings

Cerebral autoregulation plays a critical role in regulating cerebral blood flow, and impaired autoregulation has been associated with worse functional and clinical outcomes in various acute brain injuries. There exists a multitude of methods to assess the autoregulatory state in patients using both invasive and non-invasive modalities. Continuous monitoring of patients in the ICU has yielded autoregulatory-derived optimal perfusion pressures that may prevent secondary injury and improve outcomes.


Measuring autoregulation continuously at the bedside is now a feasible option for clinicians working in the ICU, although there exists a great need to standardize autoregulatory measurement. While the clinical benefits await prospective and randomized trials, autoregulation-derived parameters show enormous potential for creating an optimal physiological environment for the injured brain.


Cerebral autoregulation Bedside monitoring Critical care Traumatic brain injury, subarachnoid hemorrhage Ischemic stroke 


Compliance with Ethical Standards

Conflict of Interest

Anson Wang, Santiago Ortega-Gutierrez, and Nils H. Petersen each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Anson Wang
    • 1
  • Santiago Ortega-Gutierrez
    • 2
  • Nils H. Petersen
    • 1
    Email author
  1. 1.Department of NeurologyYale School of MedicineNew HavenUSA
  2. 2.Department of Neurology, Neurosurgery and RadiologyUniversity of IowaIowa CityUSA

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