Emergency Department, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
Department of Neurologic Diseases, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia.
Medicina (Kaunas). 2024 Aug 23;60(9):1381. doi: 10.3390/medicina60091381.
Cardiac arrest remains one of the leading causes of death. After successful resuscitation of patients in cardiac arrest, post-cardiac arrest syndrome develops, part of it being an impaired cerebral blood flow autoregulation. Monitoring cerebral blood flow autoregulation after cardiac arrest is important for optimizing patient care and prognosticating patients' survival, yet remains a challenge. There are still gaps in clinical implications and everyday use. In this article, we present a systematic review of studies with different methods of monitoring cerebral blood flow autoregulation after non-traumatic cardiac arrest. : A comprehensive literature search was performed from 1 June 2024 to 27 June 2024 by using multiple databases: PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials. Inclusion criteria were studies with an included description of the measurement of cerebral blood flow autoregulation in adult patients after non-traumatic cardiac arrest. A total of 16 studies met inclusion criteria. Our data show that the most used methods in the reviewed studies were near-infrared spectroscopy and transcranial Doppler. The most used mathematical methods for calculating cerebral autoregulation were cerebral oximetry index, tissue oxygenation reactivity index, and mean flow index. The use of various monitoring and mathematical methods for calculating cerebral blood flow autoregulation poses a challenge for standardization, validation, and daily use in clinical practice. In the future studies, focus should be considered on clinical validation and transitioning autoregulation monitoring techniques to everyday clinical practice, which could improve the survival outcomes of patients after cardiac arrest.
心脏骤停仍然是导致死亡的主要原因之一。在心脏骤停患者成功复苏后，会出现心搏骤停后综合征，其中一部分是脑血流自动调节受损。监测心脏骤停后脑血流自动调节对于优化患者护理和预测患者生存至关重要，但仍然具有挑战性。在临床意义和日常应用方面仍然存在差距。在本文中，我们对不同监测非创伤性心脏骤停后脑血流自动调节方法的研究进行了系统评价。方法：使用多个数据库（PubMed、Web of Science 和 Cochrane 对照试验中心注册）于 2024 年 6 月 1 日至 2024 年 6 月 27 日进行了全面的文献检索。纳入标准为描述了非创伤性心脏骤停后成人患者脑血流自动调节测量的研究。共有 16 项研究符合纳入标准。我们的数据表明，在综述研究中最常用的方法是近红外光谱和经颅多普勒。用于计算脑自动调节的最常用的数学方法是脑氧饱和度指数、组织氧合反应性指数和平均血流指数。各种监测和计算脑血流自动调节的数学方法的使用给标准化、验证和日常临床实践中的应用带来了挑战。在未来的研究中，应考虑将自动调节监测技术的临床验证和转化为日常临床实践，这可以提高心脏骤停后患者的生存结局。
