Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 16:12:732176.
doi: 10.3389/fneur.2021.732176. eCollection 2021.

Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review

Yaroslava Longhitano  1 , Francesca Iannuzzi  2 , Giulia Bonatti  3 , Christian Zanza  4 , Antonio Messina  5   6 , Daniel Godoy  7 , Wojciech Dabrowski  8 , Li Xiuyun  9 , Marek Czosnyka  10 , Paolo Pelosi  2   11 , Rafael Badenes  12 , Chiara Robba  2   11
Affiliations

Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review

Yaroslava Longhitano et al. Front Neurol. .

Abstract

Introduction: Cerebral autoregulation (CA) plays a fundamental role in the maintenance of adequate cerebral blood flow (CBF). CA monitoring, through direct and indirect techniques, may guide an appropriate therapeutic approach aimed at improving CBF and reducing neurological complications; so far, the role of CA has been investigated mainly in brain-injured patients. The aim of this study is to investigate the role of CA in non-brain injured patients. Methods: A systematic consultation of literature was carried out. Search terms included: "CA and sepsis," "CA and surgery," and "CA and non-brain injury." Results: Our research individualized 294 studies and after screening, 22 studies were analyzed in this study. Studies were divided in three groups: CA in sepsis and septic shock, CA during surgery, and CA in the pediatric population. Studies in sepsis and intraoperative setting highlighted a relationship between the incidence of sepsis-associated delirium and impaired CA. The most investigated setting in the pediatric population is cardiac surgery, but the role and measurement of CA need to be further elucidated. Conclusion: In non-brain injured patients, impaired CA may result in cognitive dysfunction, neurological damage, worst outcome, and increased mortality. Monitoring CA might be a useful tool for the bedside optimization and individualization of the clinical management in this group of patients.

Keywords: cerebral autoregulation; neurologic outcome; non-brain injury; pediatric surgery; perioperative care; sepsis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart.
See this image and copyright information in PMC

References

    1. Armstead WM. Cerebral blood flow autoregulation and dysautoregulation. Anesthesiol Clin. (2016) 34:465–77. 10.1016/j.anclin.2016.04.002 - DOI - PMC - PubMed
    1. Robba C, Citerio G. How I manage intracranial hypertension. Crit Care. (2019) 23:243. 10.1186/s13054-019-2529-z - DOI - PMC - PubMed
    1. Robba C, Bonatti G, Battaglini D, Rocco PRM, Pelosi P. Mechanical ventilation in patients with acute ischaemic stroke: from pathophysiology to clinical practice. Crit Care. (2019) 23:388. 10.1186/s13054-019-2662-8 - DOI - PMC - PubMed
    1. Rivera-Lara L, Zorrilla-Vaca A, Geocadin RG, Healy RJ, Ziai W, Mirski MA. Cerebral autoregulation-oriented therapy at the bedside: a comprehensive review. Anesthesiology. (2017) 126:1187–99. 10.1097/ALN.0000000000001625 - DOI - PubMed
    1. Klein SP, Depreitere B, Meyfroidt G. How I monitor cerebral autoregulation. Crit Care. (2019) 23:160. 10.1186/s13054-019-2454-1 - DOI - PMC - PubMed

Publication types