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February 20, 2015Clinical Science

Impact of transient hypotension on regional cerebral blood flow in humans

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Key result

Progressive hypotension with hypocapnia resulted in a 28 ml/min greater decline in vertebral artery blood flow compared to hypotension without hypocapnia (P=0.002).

Why the study?

Does hypocapnia during progressive hypotension alter regional cerebral blood flow and intracranial velocities in humans?

Population

Human participants

Comparison

Progressive lower-body negative pressure until… vs Progressive lower-body negative pressure until…

Design

Other

Authors

NLNia C. S. LewisKSKurt J. SmithABAnthony R. Bain

Discussion

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Overview

Alerts to CO2 modulation of posterior cerebral flow during hypotension; leaves open targeted perioperative strategies.

Structured PICO

Does hypocapnia during progressive hypotension alter regional cerebral blood flow and intracranial velocities in humans?

P
Population
Human participants
I
Intervention
Progressive lower-body negative pressure (LBNP) until pre-syncope to inflict hypotension with uncontrolled end-tidal carbon dioxide (poikilocapnic trial)
C
Comparator
Progressive lower-body negative pressure (LBNP) until pre-syncope to inflict hypotension with end-tidal carbon dioxide clamped at baseline levels (isocapnic trial)
O
Outcome
Regional extracranial cerebral blood flow (internal carotid artery and vertebral artery) and intracranial velocities (middle cerebral artery and posterior cerebral artery)surrogate

Main Result

Mean Difference: -28

p-value: p=0.002

Vertebral artery blood flow is sensitive to both hypotension and hypocapnia, and arterial constriction in the internal carotid and vertebral arteries contributes to the decline in global cerebral blood flow during systemic hypotension.

Cite This Study

Lewis et al. (2015) studied this question. Progressive hypotension with hypocapnia (poikilocapnic trial) vs. Progressive hypotension without hypocapnia (isocapnic trial) was evaluated on Decline in vertebral artery blood flow (VABF) (MD -28 ml/min, p=0.002). Progressive hypotension with hypocapnia resulted in a 28 ml/min greater decline in vertebral artery blood flow compared to hypotension without hypocapnia (P=0.002).

synapsesocial.com/papers/6a45ad576f4bbfd563da313fhttps://doi.org/10.1042/cs20140751
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