naa a22 4500 510799310 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-013-9857-7 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9857-7 Cerebrovascular Pressure Reactivity and Cerebral Oxygen Regulation After Severe Head Injury [Elektronische Daten] [Matthias Jaeger, Erhard Lang] Background: To investigate the relationship between cerebrovascular pressure reactivity and cerebral oxygen regulation after head injury. Methods: Continuous monitoring of the partial pressure of brain tissue oxygen (PbrO2), mean arterial blood pressure (MAP), and intracranial pressure (ICP) in 11 patients. The cerebrovascular pressure reactivity index (PRx) was calculated as the moving correlation coefficient between MAP and ICP. For assessment of the cerebral oxygen regulation system a brain tissue oxygen response (TOR) was calculated, where the response of PbrO2 to an increase of the arterial oxygen through ventilation with 100% oxygen for 15min is tested. Arterial blood gas analysis was performed before and after changing ventilator settings. Results: Arterial oxygen increased from 108±6mmHg to 494±68mmHg during ventilation with 100% oxygen. PbrO2 increased from 28±7mmHg to 78±29mmHg, resulting in a mean TOR of 0.48±0.24. Mean PRx was 0.05±0.22. The correlation between PRx and TOR was r=0.69, P=0.019. The correlation of PRx and TOR with the Glasgow outcome scale at 6months was r=0.47, P=0.142; and r=−0.33, P=0.32, respectively. Conclusions: The results suggest a strong link between cerebrovascular pressure reactivity and the brain's ability to control for its extracellular oxygen content. Their simultaneous impairment indicates that their common actuating element for cerebral blood flow control, the cerebral resistance vessels, are equally impaired in their ability to regulate for MAP fluctuations and changes in brain oxygen. Springer Science+Business Media New York, 2013 Brain tissue oxygen nationallicence Neuromonitoring nationallicence Brain tissue oxygen response nationallicence Cerebrovascular pressure reactivity nationallicence Head injury nationallicence Autoregulation nationallicence Jaeger Matthias Department of Neurosurgery, Liverpool Hospital, University of New South Wales and University of Western Sydney, Locked Bag 7103, 1871, Liverpool BC, NSW, Australia aut Lang Erhard Neurosurgical Associates, Red-Cross Hospital, Bergmannstraße 30, 34121, Kassel, Germany aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 69-73 1541-6933 19:1<69 2013 19 12028 https://doi.org/10.1007/s12028-013-9857-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9857-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jaeger Matthias Department of Neurosurgery, Liverpool Hospital, University of New South Wales and University of Western Sydney, Locked Bag 7103, 1871, Liverpool BC, NSW, Australia aut NATIONALLICENCE 700 1- Lang Erhard Neurosurgical Associates, Red-Cross Hospital, Bergmannstraße 30, 34121, Kassel, Germany aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 69-73 1541-6933 19:1<69 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer