Impaired cerebral autoregulation is associated with brain dysfunction in patients with sepsis

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RECERCAT Home > Universitat Internacional de Catalunya > Recerca > Articles > Ciències de la Salut > View document

To access the full text documents, please follow this link: http://hdl.handle.net/20.500.12328/1407

dc.contributor.author	Crippa, Ilaria Alice
dc.contributor.author	Subirà Cuyàs, Carles
dc.contributor.author	Vincent, Jean-Louis
dc.contributor.author	Fernández Fernández, Rafael
dc.contributor.author	Cano Hernandez, Silvia
dc.contributor.author	Zama Cavicchi, Federica
dc.contributor.author	Creteur, Jacques
dc.contributor.author	Taccone, Fabio Silvio
dc.date	2019-12-23T16:33:56Z
dc.date	2019-12-23T16:33:56Z
dc.date	2018-12-04
dc.identifier	Crippa, Ilaria Alice; Subirà, Carles; Vincent, Jean-Louis [et al.]. Impaired cerebral autoregulation is associated with brain dysfunction in patients with sepsis. Critical Care, 2018, vol. 22, p. 1-9. Disponible en: <https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2258-8#rightslink>. Fecha de acceso: 23 dic. 2019. DOI: 10.1186/s13054-018-2258-8
dc.identifier	1364-8535
dc.identifier	https://dx.doi.org/10.1186/s13054-018-2258-8
dc.identifier.uri	http://hdl.handle.net/20.500.12328/1407
dc.description	Background: Sepsis-associated brain dysfunction (SABD) is associated with high morbidity and mortality. The pathophysiology of SABD is multifactorial. One hypothesis is that impaired cerebral autoregulation (CAR) may result in brain hypoperfusion and neuronal damage leading to SABD. Methods: We studied 100 adult patients with sepsis (July 2012–March 2017) (age = 62 [52–71] years; Acute Physiology and Chronic Health Evaluation II score on admission = 21 [15–26]). Exclusion criteria were acute or chronic intracranial disease, arrhythmias, extracorporeal membrane oxygenation, and known intra- or extracranial supra-aortic vessel disease. The site of infection was predominantly abdominal (46%) or pulmonary (28%). Transcranial Doppler was performed, insonating the left middle cerebral artery with a 2-MHz probe. Middle cerebral artery blood flow velocity (FV) and arterial blood pressure (ABP) signals were recorded simultaneously; Pearson’s correlation coefficient (mean flow index [Mxa]) between ABP and FV was calculated using MATLAB. Impaired CAR was defined as Mxa > 0.3. Results: Mxa was 0.29 [0.05–0.62]. CAR was impaired in 50 patients (50%). In a multiple linear regression analysis, low mean arterial pressure, history of chronic kidney disease and fungal infection were associated with high Mxa. SABD was diagnosed in 57 patients (57%). In a multivariable analysis, altered cerebral autoregulation, mechanical ventilation and history of vascular disease were independent predictors of SABD. Conclusions: Cerebral autoregulation was altered in half of the patients with sepsis and was associated with the development of SABD. These findings support the concept that cerebral hypoxia could contribute to the development of SABD.
dc.format	9
dc.format	application/pdf
dc.language	eng
dc.publisher	Springer Nature
dc.relation	Critical Care
dc.relation	22;
dc.rights	This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.rights	http://creativecommons.org/licenses/by/4.0/
dc.subject	Cervell -- Degeneració
dc.subject	Circulació cerebral
dc.subject	Ecoencefalografia
dc.subject	Cerebro -- Disfunción
dc.subject	Circulación cerebrovascular
dc.subject	Ecoencefalografía
dc.subject	Cerebrovascular circulation
dc.subject	Cerebral blood flow
dc.subject	Brain dysfunction
dc.subject	61
dc.title	Impaired cerebral autoregulation is associated with brain dysfunction in patients with sepsis
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/acceptedVersion

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