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The effect of burst suppression on cerebral blood flow and autoregulation: a scoping review of the human and animal literature.

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Peer-reviewed

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Authors

Siddiqi, A Zohaib 
Froese, Logan 
Gomez, Alwyn 
Sainbhi, Amanjyot Singh 
Stein, Kevin 

Abstract

Background: Burst suppression (BS) is an electroencephalography (EEG) pattern in which there are isoelectric periods interspersed with bursts of cortical activity. Targeting BS through anaesthetic administration is used as a tool in the neuro-intensive care unit but its relationship with cerebral blood flow (CBF) and cerebral autoregulation (CA) is unclear. We performed a systematic scoping review investigating the effect of BS on CBF and CA in animals and humans. Methods: We searched MEDLINE, BIOSIS, EMBASE, SCOPUS and Cochrane library from inception to August 2022. The data that were collected included study population, methods to induce and measure BS, and the effect on CBF and CA. Results: Overall, there were 66 studies that were included in the final results, 41 of which examined animals, 24 of which examined humans, and 1 of which examined both. In almost all the studies, BS was induced using an anaesthetic. In most of the animal and human studies, BS was associated with a decrease in CBF and cerebral metabolism, even if the mean arterial pressure remained constant. The effect on CA during periods of stress (hypercapnia, hypothermia, etc.) was variable. Discussion: BS is associated with a reduction in cerebral metabolic demand and CBF, which may explain its usefulness in patients with brain injury. More evidence is needed to elucidate the connection between BS and CA.

Description

Peer reviewed: True

Keywords

burst suppression, cerebral autoregulation (CA), cerebral blood flow (CBF), cerebrovascular physiology, neuroanaesthesia, systematic review

Journal Title

Front Physiol

Conference Name

Journal ISSN

1664-042X
1664-042X

Volume Title

Publisher

Frontiers Media SA