| Co2-dependent vasomotor reactivity of cerebral arteries in patients with severe traumatic brain injury: time course and effect of augmentation of cardiac output with dobutamine. | |
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MedLine Citation:
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PMID: 21501044 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Failing cerebral blood flow autoregulation may contribute to cerebral damage after traumatic brain injury (TBI). The purpose of this study was to describe the time course of CO2-dependent autoregulation, measured as cerebral blood flow velocity in response to hyperventilation (vasomotor reactivity index [VMI]). We included 13 patients after severe TBI, eight of whom received norepinephrine (NE) based on clinical indication. In these patients, measurements were also performed after dobutamine administration, with a goal of increasing cardiac output by 30%. Blood flow velocity was measured with transcranial doppler in both hemispheres. All patients except one had an abnormal VMR index in at least one hemisphere within the first 24 hours after TBI. In those patients who did not receive catecholamines, mean VMR index recovered within the first 48 to 72 hours. In contrast, VMR index did not recover on the second day in patients who received NA within the first 48 h period. Cardiac output and mean cerebral blood flow velocity increased significantly during dobutamine administration, but VMR index did not change significantly. In conclusion, CO2 vasomotor reactivity was abnormal in the first 24 hours after TBI in most of the patients, but recovered within 48 hours in those patients who did not receive norepinephrine, in contrast to those eventually receiving the drug. Addition of dobutamine to norepinephrine had variable but overall insignificant effects on CO2 vasomotor reactivity. |
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Authors:
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Matthias Haenggi; Anna Andermatt; Claudia Anthamatten; Aikaterini Galimanis; Marie-Louise Mono; Alexander Alfieri; Christian Fung; Jukka Takala |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-18 |
Journal Detail:
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Title: Journal of neurotrauma Volume: - ISSN: 1557-9042 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8811626 Medline TA: J Neurotrauma Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Bern University Hospital and University of Bern, Department of Intensive Care Medicine, Inselspital, Bern, Switzerland, CH-3010, +4131 632 3029, +4131 632 2496; matthias.haenggi@insel.ch. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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