Manaaki Mānawa - The Centre for Heart Research, Department of Physiology, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand.
Neurology Department, School of Medicine, Hospital das Clinicas, University of São Paulo, São Paulo, Brazil.
J Cereb Blood Flow Metab. 2022 Mar;42(3):454-470. doi: 10.1177/0271678X211033732. Epub 2021 Jul 26.
Restoring perfusion to ischemic tissue is the primary goal of acute ischemic stroke care, yet only a small portion of patients receive reperfusion treatment. Since blood pressure (BP) is an important determinant of cerebral perfusion, effective BP management could facilitate reperfusion. But how BP should be managed in very early phase of ischemic stroke remains a contentious issue, due to the lack of clear evidence. Given the complex relationship between BP and cerebral blood flow (CBF)-termed cerebral autoregulation (CA)-bedside monitoring of cerebral perfusion and oxygenation could help guide BP management, thereby improve stroke patient outcome. The aim of INFOMATAS is to ''. In this review, we identify novel physiological parameters which could be used to guide BP management in acute stroke, and explore methodologies for monitoring them at the bedside. We outline the challenges in translating these potential prognostic markers into clinical use.
恢复缺血组织的灌注是急性缺血性脑卒中治疗的首要目标,但只有一小部分患者接受再灌注治疗。由于血压(BP)是脑灌注的重要决定因素,有效的 BP 管理可以促进再灌注。但是,由于缺乏明确的证据,缺血性脑卒中非常早期阶段的 BP 应该如何管理仍然是一个有争议的问题。鉴于 BP 和脑血流(CBF)之间的复杂关系,称为脑自动调节(CA),脑灌注和氧合的床边监测可以帮助指导 BP 管理,从而改善脑卒中患者的预后。INFOMATAS 的目的是“......”。在这篇综述中,我们确定了可用于指导急性脑卒中 BP 管理的新的生理参数,并探讨了在床边监测它们的方法。我们概述了将这些潜在的预后标志物转化为临床应用的挑战。