Department of Anesthesiology and Pain Medicine.
Harborview Injury Prevention and Research Center.
J Neurosurg Anesthesiol. 2023 Oct 1;35(4):354-360. doi: 10.1097/ANA.0000000000000933. Epub 2023 Jul 31.
Cerebral autoregulation (CA) plays a vital role in maintaining cerebral blood flow in response to changes in systemic blood pressure. Impairment of CA following traumatic brain injury (TBI) may exacerbate the injury, potentially impacting patient outcomes. This focused review addresses 4 key questions regarding the measurement, natural history of CA after TBI, and potential clinical implications of CA status and CA-guided management in adults and children with TBI. We examine the feasibility and safety of CA assessment, its association with clinical outcomes, and the potential for reversing deranged CA following TBI. Finally, we discuss how the knowledge of CA status may affect TBI management and outcomes.
脑自动调节（CA）在响应全身血压变化以维持脑血流方面起着至关重要的作用。创伤性脑损伤（TBI）后 CA 的损害可能会使损伤恶化，从而对患者的预后产生影响。本重点综述针对成人和儿童 TBI 后 CA 的测量、CA 的自然史以及 CA 状态和 CA 指导管理的潜在临床意义这 4 个关键问题进行了探讨。我们检查了 CA 评估的可行性和安全性、它与临床结果的相关性，以及纠正 TBI 后异常 CA 的可能性。最后，我们讨论了 CA 状态的知识如何影响 TBI 的管理和结果。
