دورية أكاديمية
Cerebral autoregulation and cerebral blood flow response to mean arterial pressure challenge following induction of general anaesthesia for neuroradiology procedure
| العنوان: | Cerebral autoregulation and cerebral blood flow response to mean arterial pressure challenge following induction of general anaesthesia for neuroradiology procedure |
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| المؤلفون: | Manquat, Elsa, Ravaux, Hugues, Souilamas, Jihane, Chamoux, Thibaut, Joaquim, Jona, Gayat, Etienne, Vallée, Fabrice, Cartailler, Jérôme |
| المساهمون: | Département d’Anesthésie-Réanimation-SMUR Hôpital Lariboisière, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Modelling brain structure, function and variability based on high-field MRI data (PARIETAL), Service NEUROSPIN (NEUROSPIN), Université Paris-Saclay-Institut des Sciences du Vivant Frédéric JOLIOT (JOLIOT), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Institut des Sciences du Vivant Frédéric JOLIOT (JOLIOT), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Service d'Anesthésie-Réanimation AP-HP Hôpitaux Saint-Louis Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal APHP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal Paris, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, ALPHABRAIN |
| المصدر: | EISSN: 2813-480X ; Frontiers in Anesthesiology ; https://hal.science/hal-04454890Test ; Frontiers in Anesthesiology, 2023, 2, pp.1169961. ⟨10.3389/fanes.2023.1169961⟩ |
| بيانات النشر: | HAL CCSD Frontiers |
| سنة النشر: | 2023 |
| المجموعة: | HAL-CEA (Commissariat à l'énergie atomique et aux énergies alternatives) |
| مصطلحات موضوعية: | cerebral autogregulation, mean arterial pressure challenge, transcranial Doppler, anesthesia, mean flow index, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie |
| الوصف: | International audience ; Introduction Intraoperative hypotension is common following general anaesthesia induction with propofol, but its impact on cerebral autoregulation (CA) remains unclear. We investigate the incidence and risk factors of impaired CApost-propofol induction and its recovery after a mean arterial pressure (mAP) challenge. Methods We included 40 non-emergency neuroradiology surgery patients [58 (47, 58)years old., 57% women]. We recorded mAP, mean blood flow velocity in the mean cerebral artery (MCAv$_{ mean}$ ), and regional cerebral oxygen saturation (rSO2). We computed the mean flow index (Mxa) pre and post mAP challenge. Mxa > 0.3 defined poor CA. Results After anaesthesia induction, 21 (53%) had impaired CBF autoregulation (CA−, Mxa < 0.3). The average mAP was 66 ± 9 mmHg, average MCAv was 39 ± 12 cm.s$^{−1}$ , and rSO 2 was 63 ± 7%. We found no significant difference in age, norepinephrine infusion rate, and cardiovascular risks factors were similar between CA− and CA+ (Mxa ≤ 0.3) patients. Among the 22 patients (CA−: n = 14; CA+: n = 8) undergoing mAP challenge, there was a significant Mxa improvement and MCAv increase among CA− patients, (CA−: 0.63 ± 0.18 vs. 0.28 ± 0.20, p < 0.001), and [absolute variation: 1 (0.7–1.5) vs. 7 (3–9) cm.sec$^{−1}$ ], respectively. Conclusion After induction of general anaesthesia for neuroradiology procedure, 53% of the patients had an impaired CA, regardless of age or medical history. Importantly, a mAP challenge effectively restored CA and improved CBF. Clinical Trial Registration identifier, NCT04288869 |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-04454890; https://hal.science/hal-04454890Test; https://hal.science/hal-04454890/documentTest; https://hal.science/hal-04454890/file/fanes-02-1169961.pdfTest |
| DOI: | 10.3389/fanes.2023.1169961 |
| الإتاحة: | https://doi.org/10.3389/fanes.2023.1169961Test https://hal.science/hal-04454890Test https://hal.science/hal-04454890/documentTest https://hal.science/hal-04454890/file/fanes-02-1169961.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.DE0833C6 |
| قاعدة البيانات: | BASE |
| DOI: | 10.3389/fanes.2023.1169961 |
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