Literature DB >> 25205587

Static autoregulation in humans: a review and reanalysis.

Tianne Numan1, Anthony R Bain2, Ryan L Hoiland2, Jonathan D Smirl2, Nia C Lewis2, Philip N Ainslie3.   

Abstract

INTRODUCTION: Cerebral autoregulation (CA) is a theoretical construct characterized by the relationship between mean arterial pressure (MAP) and cerebral blood flow (CBF). We performed a comprehensive literature search to provide an up-to-date review on the static relationship between MAP and CBF.
METHODS: The results are based on 40 studies (49 individual experimental protocols) in healthy subjects between 18 and 65 years. Exclusion criteria were: a ΔMAP <5%, hypoxia/hyperoxia or hypo/hypercapnia, and unstable levels (<2 min stages). The partial pressure of arterial CO2 (PaCO2) was measured in a subset of the included studies (n=28); therefore, CBF was also adjusted to account for small changes in PaCO2.
RESULTS: The linear regression coefficient between MAP and CBF (or velocity) of 0.82±0.77%ΔCBF/%ΔMAP during decreases in MAP (n=23 experiments) was significantly different than the relationship of 0.21±0.47%ΔCBF/%ΔMAP during increases (n=26 experiments; p<0.001). After correction for increases/decreases in PaCO2, the slopes were not significantly different: 0.64±1.16%ΔCBF/%ΔMAP (n=16) and 0.39±0.30%ΔCBF/%ΔMAP (n=12) for increased vs. decreased MAP changes, respectively (p=0.60).
CONCLUSION: The autoregulatory ability of the cerebral circulation appears to be more active in buffering increases in MAP as compared to reductions in MAP. However, the statistical finding of hysteresis is lost following an attempt to correct for PaCO2.
Copyright © 2014. Published by Elsevier Ltd.

Entities:  

Keywords:  Blood pressure; Cerebral autoregulation; Cerebral blood flow; Cerebrovascular CO(2) reactivity

Mesh:

Substances:

Year:  2014        PMID: 25205587     DOI: 10.1016/j.medengphy.2014.08.001

Source DB:  PubMed          Journal:  Med Eng Phys        ISSN: 1350-4533            Impact factor:   2.242


  39 in total

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