TY - JOUR
T1 - Cerebral Autoregulation in Non-Brain Injured Patients: A Systematic Review
AU - Longhitano, Yaroslava
AU - Iannuzzi, Francesca
AU - Bonatti, Giulia
AU - Zanza, Christian
AU - Messina, Antonio
AU - Godoy, Daniel
AU - Dabrowski, Wojciech
AU - Xiuyun, Li
AU - Czosnyka, Marek
AU - Pelosi, Paolo
AU - Badenes, Rafael
AU - Robba, Chiara
N1 - Publisher Copyright:
Copyright © 2021 Longhitano, Iannuzzi, Bonatti, Zanza, Messina, Godoy, Dabrowski, Xiuyun, Czosnyka, Pelosi, Badenes and Robba.
PY - 2021/11/16
Y1 - 2021/11/16
N2 - Introduction: Cerebral autoregulation (CA) plays a fundamental role in the maintenance of adequate cerebral blood flow (CBF). CA monitoring, through direct and indirect techniques, may guide an appropriate therapeutic approach aimed at improving CBF and reducing neurological complications; so far, the role of CA has been investigated mainly in brain-injured patients. The aim of this study is to investigate the role of CA in non-brain injured patients. Methods: A systematic consultation of literature was carried out. Search terms included: “CA and sepsis,” “CA and surgery,” and “CA and non-brain injury.” Results: Our research individualized 294 studies and after screening, 22 studies were analyzed in this study. Studies were divided in three groups: CA in sepsis and septic shock, CA during surgery, and CA in the pediatric population. Studies in sepsis and intraoperative setting highlighted a relationship between the incidence of sepsis-associated delirium and impaired CA. The most investigated setting in the pediatric population is cardiac surgery, but the role and measurement of CA need to be further elucidated. Conclusion: In non-brain injured patients, impaired CA may result in cognitive dysfunction, neurological damage, worst outcome, and increased mortality. Monitoring CA might be a useful tool for the bedside optimization and individualization of the clinical management in this group of patients.
AB - Introduction: Cerebral autoregulation (CA) plays a fundamental role in the maintenance of adequate cerebral blood flow (CBF). CA monitoring, through direct and indirect techniques, may guide an appropriate therapeutic approach aimed at improving CBF and reducing neurological complications; so far, the role of CA has been investigated mainly in brain-injured patients. The aim of this study is to investigate the role of CA in non-brain injured patients. Methods: A systematic consultation of literature was carried out. Search terms included: “CA and sepsis,” “CA and surgery,” and “CA and non-brain injury.” Results: Our research individualized 294 studies and after screening, 22 studies were analyzed in this study. Studies were divided in three groups: CA in sepsis and septic shock, CA during surgery, and CA in the pediatric population. Studies in sepsis and intraoperative setting highlighted a relationship between the incidence of sepsis-associated delirium and impaired CA. The most investigated setting in the pediatric population is cardiac surgery, but the role and measurement of CA need to be further elucidated. Conclusion: In non-brain injured patients, impaired CA may result in cognitive dysfunction, neurological damage, worst outcome, and increased mortality. Monitoring CA might be a useful tool for the bedside optimization and individualization of the clinical management in this group of patients.
KW - cerebral autoregulation
KW - neurologic outcome
KW - non-brain injury
KW - pediatric surgery
KW - perioperative care
KW - sepsis
UR - http://www.scopus.com/inward/record.url?scp=85120706237&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120706237&partnerID=8YFLogxK
U2 - 10.3389/fneur.2021.732176
DO - 10.3389/fneur.2021.732176
M3 - Review article
AN - SCOPUS:85120706237
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
SN - 1664-2295
M1 - 732176
ER -