Neonatal cerebrovascular autoregulation.
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Authors
Rhee, Christopher J
da Costa, Cristine Sortica
Brady, Ken M
Lee, Jennifer K
Publication Date
2018-11Journal Title
Pediatr Res
ISSN
0031-3998
Publisher
Springer Science and Business Media LLC
Volume
84
Issue
5
Pages
602-610
Language
eng
Type
Article
This Version
AM
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Rhee, C. J., da Costa, C. S., Austin, T., Brady, K. M., Czosnyka, M., & Lee, J. K. (2018). Neonatal cerebrovascular autoregulation.. Pediatr Res, 84 (5), 602-610. https://doi.org/10.1038/s41390-018-0141-6
Abstract
Cerebrovascular pressure autoregulation is the physiologic mechanism that holds cerebral blood flow (CBF) relatively constant across changes in cerebral perfusion pressure (CPP). Cerebral vasoreactivity refers to the vasoconstriction and vasodilation that occur during fluctuations in arterial blood pressure (ABP) to maintain autoregulation. These are vital protective mechanisms of the brain. Impairments in pressure autoregulation increase the risk of brain injury and persistent neurologic disability. Autoregulation may be impaired during various neonatal disease states including prematurity, hypoxic-ischemic encephalopathy (HIE), intraventricular hemorrhage, congenital cardiac disease, and infants requiring extracorporeal membrane oxygenation (ECMO). Because infants are exquisitely sensitive to changes in cerebral blood flow (CBF), both hypoperfusion and hyperperfusion can cause significant neurologic injury. We will review neonatal pressure autoregulation and autoregulation monitoring techniques with a focus on brain protection. Current clinical therapies have failed to fully prevent permanent brain injuries in neonates. Adjuvant treatments that support and optimize autoregulation may improve neurologic outcomes.
Keywords
Arterial Pressure, Cerebrovascular Circulation, Extracorporeal Membrane Oxygenation, Homeostasis, Humans, Infant, Infant, Newborn, Infant, Newborn, Diseases, Monitoring, Physiologic, Spectroscopy, Near-Infrared
Identifiers
External DOI: https://doi.org/10.1038/s41390-018-0141-6
This record's URL: https://www.repository.cam.ac.uk/handle/1810/287047
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