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Cerebral Oximetry Index-Guided Blood Pressure Management During Cardiopulmonary Bypass Reduces Postoperative Delirium in Patients with Acute Type A Aortic Dissection.
J Cardiothorac Vasc Anesth
January 2025
Department of Anesthesiology, The Yangzhou Clinical Medical College of Xuzhou Medical University, Yangzhou, Jiangsu Province, China. Electronic address:
Objective(s): To investigate whether cerebral oximetry index (COx)-guided blood pressure management during cardiopulmonary bypass (CPB) could reduce postoperative delirium (POD) in patients undergoing acute type A aortic dissection (ATAAD) repair.
Design: A prospective, randomized controlled trial.
Setting: Patients undergoing ATAAD repair with CPB.
Cardiopulmonary bypass (CPB) in cardiac surgery is associated with a high risk of postoperative neurological complications. Perioperative use of vasopressors is common to counteract arterial hypotension in this setting. However, use of α-agonist vasopressors has been associated with cerebral desaturations.
View Article and Find Full Text PDFReference Ranges for Cerebral Oxygenation in Neonates During Immediate Transition After Birth: Differences Between Devices.
Acta Paediatr
January 2025
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Aim: The aim was to define reference ranges for cerebral oxygen saturation (crSO-ROOT) during immediate transition after birth in stable neonates.
Methods: In a prospective observational study, the crSO-ROOT was continuously measured in neonates during the first 15 min after birth. The neonatal sensor was placed on the head and fixed with a bandage.
Venous compression causes chronic cerebral ischaemia in normal pressure hydrocephalus patients.
Fluids Barriers CNS
January 2025
Department of Neurosurgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Background: Cerebral autoregulation is a robust regulatory mechanism that stabilizes cerebral blood flow in response to reduced blood pressure, thereby preventing cerebral ischaemia. Scientists have long believed that cerebral autoregulation also stabilizes cerebral blood flow against increases in intracranial pressure, which is another component that determines cerebral perfusion pressure. However, this idea was inconsistent with the complex pathogenesis of normal pressure hydrocephalus, which includes components of chronic cerebral ischaemia due to mild increases in intracranial pressure.
View Article and Find Full Text PDFThe Impact of Blood Pressure Below Personalized Lower Cerebral Autoregulation Limit on Outcomes After Cardiac Surgery: A Retrospective Study.
J Cardiothorac Vasc Anesth
December 2024
Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address:
Objective: The clinical importance of individualized blood pressure management in optimizing cerebral perfusion during cardiac surgery has been well established. However, consensus on blood pressure goals is lacking. The authors studied the associations between cerebral autoregulation metrics, hemodynamic parameters, and postoperative outcomes, and hypothesized that increased time of mean arterial pressure (MAP) below the lower limit of autoregulation (LLA) is associated with major morbidity and mortality (MMOM) incidence.
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