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Review
. 2022 Jul;22(7):282-288.
doi: 10.1016/j.bjae.2022.02.005. Epub 2022 Apr 20.

Cerebral circulation II: pathophysiology and monitoring

Andrea Lavinio  1
Affiliations
Review

Cerebral circulation II: pathophysiology and monitoring

Andrea Lavinio. BJA Educ. 2022 Jul.

Erratum in

No abstract available

Keywords: anaesthesia; cerebrovascular circulation; delirium.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig 1
Fig 1
The oxygen extraction fraction (OEF) of the brain is the ratio between cerebral oxygen delivery and cerebral metabolic rate of oxygen (CMRO2). Oxygen delivery can be compromised by a reduction in cerebral blood flow (CBF) or arterial content of oxygen (Cao2), leading to hypoperfusion. Prompt recognition of hypoperfusion allows the prevention of ischaemia by means of anaesthetic titration, blood pressure, and temperature and ventilation management.
Fig 2
Fig 2
Transcranial Doppler (TCD) findings with increasing ICP and progressively compromised cerebral perfusion pressure (CPP). LOW ICP: in healthy brains, normal CBFv waveforms closely resemble that of arterial blood pressure waveform (note continuous diastolic flow); HIGH ICP: as ICP increases, diastolic CBFv becomes progressively compromised; ICP≥DBP: as ICP exceeds diastolic blood pressure (DBP) diastolic flow drops to zero. ICP≈MAP: as ICP approaches mean arterial pressure and CPP approaches zero cerebral circulatory arrest can be demonstrated by a pattern of diastolic flow reversal. CBFv, cerebral blood flow velocity; MCA FV, middle cerebral artery flow velocity.
See this image and copyright information in PMC

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