All patients had impaired cerebral autoregulation during their monitoring time.
A tool for monitoring autoregulation and determining an optimal CPP is the pressure reactivity index (PRx), defined as a moving correlation coefficient between the mean arterial blood pressure (MAP) and intracranial pressure (ICP) at a frequency of at least 60 Hz.
It would be valuable if, for example, monitoring of autoregulation could be used to quantify the effects of an inflammatory insult to the brain.
Several dynamic pressure reactivity indices have been proposed for monitoring cerebrovascular autoregulation in real time at the bedside, by calculating the correlation between the arterial blood pressure and continuous measures of CBF or cerebral blood volume [ 30].
We present its application for continuous monitoring of cerebral autoregulation using near-infrared spectroscopy (NIRS).
Although this study incorporated patients with pressure waveform modifications, these were continuously sustained over days, leading to a stable blood waveform pattern; for this reason, the authors considered that the cross-correlation method could be appropriate for the continuous monitoring of cerebral autoregulation.
This classification created four classes, which we termed (I) double-autoregulation, (II) intermediary-only autoregulated, (III) originating-only autoregulated and (IV) no autoregulation.
We also defined the impaired autoregulation index (IARindex) as the percentage of monitoring time spent with an impaired autoregulation.
ICM+ software is proving to be a very useful tool for enhancing the battery of available means for monitoring cerebral vasoreactivity and potentially facilitating autoregulation guided therapy.
To validate the autoregulation of GCM1 and GCM2 in mammals, we monitored their levels of expression in HeLa cells transfected with expression vectors for mGcm1 and mGcm2.
Patients were monitored with continuous ECG, ICP, cerebral perfusion pressure, cerebral autoregulation with pressure reactivity and pressure-volume compensatory reserve index (RAP).
