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Correlation Between Cerebral Autoregulation and Carbon Dioxide Reactivity in Patients with Traumatic Brain Injury

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Intracranial Pressure and Brain Monitoring XV

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 122))

Abstract

Objective: Cerebral blood flow autoregulation is commonly impaired in patients with traumatic brain injury (TBI). This study was to investigate correlations between cerebral autoregulation and CO2 reactivity in patients with TBI during transient mild hypocapnia. Methods: Patients with TBI who were on mechanical ventilation were hyperventilated for approximately 60 min. Indices of autoregulation, based on a model of the relationship between arterial blood pressure and blood flow velocity (FV) (ARIabp) and, separately, between cerebral perfusion pressure and FV (ARIcpp), were calculated. Mean flow index (Mx) was also calculated. Results: We investigated 31 consecutive patients. At baseline, median PaCO2 was 5.09 kPa (range 4.30–5.67 kPa); during hyperventilation, median PaCO2 was 4.38 kPa (range 3.72–4.96 kPa). ARI was associated with Mx (ARIabp vs. Mx: r = −0.39, p = 0.04; ARIcpp vs Mx: r = −0.67, p < 0.001). CO2 reactivity showed significant correlation with ARIcpp (r = 0.41, p = 0.04) and Mx (r = −0.37, p = 0.04). ARI after hyperventilation was significantly higher than ARI at baseline (ARIcpp: p = 0.02; ARIabp: p < 0.001). Conclusions: Cerebral autoregulation seemed to be well linked to CO2 reactivity during transient hyperventilation. ARIcpp had a stronger correlation with CO2 reactivity than ARIabp. ARI indicated improvement of autoregulation during hyperventilation. Cerebral autoregulation indices (ARI, Mx) were associated with each other.

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Conflict of Interest Statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Cambridge, Cambridge, UK

    Yi Zhang MD, Xiuyun Liu, Luzius Steiner PhD & John D. Pickard FMedSci

  2. Department of Neurology, University of Rochester Medical Center, 601 Elmwood Avenue, 673, Rochester, NY, 14642, USA

    Yi Zhang MD

  3. Department of Neurology, Saint Louis University, Saint Louis, MO, USA

    Yi Zhang MD & Eli Feen MD

  4. Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK

    Peter Smielewski PhD & Marek Czosnyka PhD

  5. Department of Anesthesiology, University Hospital in Basel, Basel, Switzerland

    Luzius Steiner PhD

Authors
  1. Yi Zhang MD
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  2. Xiuyun Liu
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  3. Luzius Steiner PhD
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  4. Peter Smielewski PhD
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  5. Eli Feen MD
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  6. John D. Pickard FMedSci
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  7. Marek Czosnyka PhD
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Corresponding author

Correspondence to Yi Zhang MD .

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Editors and Affiliations

  1. Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore

    Beng-Ti Ang

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© 2016 Springer International Publishing Switzerland

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Zhang, Y. et al. (2016). Correlation Between Cerebral Autoregulation and Carbon Dioxide Reactivity in Patients with Traumatic Brain Injury. In: Ang, BT. (eds) Intracranial Pressure and Brain Monitoring XV. Acta Neurochirurgica Supplement, vol 122. Springer, Cham. https://doi.org/10.1007/978-3-319-22533-3_41

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  • DOI: https://doi.org/10.1007/978-3-319-22533-3_41

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-22532-6

  • Online ISBN: 978-3-319-22533-3

  • eBook Packages: MedicineMedicine (R0)

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