Cerebral Critical Closing Pressure: Is the Multiparameter Model Better Suited to Estimate Physiology of Cerebral Hemodynamics?

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• 作者：C. Puppo ; J. Camacho ; G. V. Varsos ; B. Yelicich ; H. Gómez ; L. Moraes…
• 关键词：Cerebral critical closing pressure ; Cerebral arterial time constant ; Intracranial pressure ; Neuromonitoring ; Transcranial doppler ; Traumatic brain injury
• 刊名：Neurocritical Care
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：25
• 期：3
• 页码：446-454
• 全文大小：
• 刊物主题：Internal Medicine; Neurology; Intensive / Critical Care Medicine;
• 出版者：Springer US
• ISSN：1556-0961
• 卷排序：25

文摘

BackgroundCerebral critical closing pressure (CrCP) is the level of arterial blood pressure (ABP) at which small brain vessels close and blood flow stops. This value is always greater than intracranial pressure (ICP). The difference between CrCP and ICP is explained by the tone of the small cerebral vessels (wall tension). CrCP value is used in several dynamic cerebral autoregulation models. However, the different methods for calculation of CrCP show frequent negative values. These findings are viewed as a methodological limitation. We intended to evaluate CrCP in patients with severe traumatic brain injury (TBI) with a new multiparameter impedance-based model and compare it with results found earlier using a transcranial Doppler (TCD)–ABP pulse waveform-based method.