ArticleActa neurochirurgica2017
Increased risk of critical CBF levels in SAH patients with actual CPP below calculated optimal CPP.
Article in Acta neurochirurgica, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Monitoring of Cerebral Blood Flow Autoregulation after Cardiac Arrest.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Individualized autoregulation-guided arterial blood pressure management in neurocritical care.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Continuous personalized cerebrovascular reactivity-based physiologic metrics in neurocritical care: a narrative review of the current landscape, limitations, and future directions.Frontiers in physiology · 2025Review
- Impaired cerebral autoregulation detected in early prevasospasm period is associated with unfavorable outcome after spontaneous subarachnoid hemorrhage: an observational prospective pilot study.The ultrasound journal · 2024Article
- Are We Ready for Clinical Therapy based on Cerebral Autoregulation? A Pro-con Debate.Neurocritical care · 2023Article
- Fine tuning of neurointensive care in aneurysmal subarachnoid hemorrhage: From one-size-fits-all towards individualized care.World neurosurgery: X · 2023Review
- Intracranial pressure- and cerebral perfusion pressure threshold-insults in relation to cerebral energy metabolism in aneurysmal subarachnoid hemorrhage.Acta neurochirurgica · 2022Article
- Review of studies on dynamic cerebral autoregulation in the acute phase of stroke and the relationship with clinical outcome.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2022Review
- Response to: "Precise Clinical Outcome in High-Grade Aneurysmal Subarachnoid Hemorrhage: Brain Oxygenation Matters!"Neurocritical care · 2021Article
- Response to: Comment on "Temporal Dynamics of ICP, CPP, PRx, and CPPopt in High‑Grade Aneurysmal Subarachnoid Hemorrhage and the Relation to Clinical Outcome".Neurocritical care · 2021Article
- Cerebral Microdialysis in Aneurismal Subarachnoid Hemorrhage Patient Reveals a Detrimental Shift in Brain Energy Metabolism, Despite Normal Perfusion Pressure.Metabolites · 2020Article
- The prognostic value of optic nerve sheath diameter in patients with subarachnoid hemorrhage.Critical care (London, England) · 2019Observational
- Neurocritical care management supported by multimodal brain monitoring after acute brain injury.Critical care scienceArticle
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCerebral pressure autoregulation can be quantified with the pressure reactivity index (PRx), based on the correlation between blood pressure and intracranial pressure. Using PRx optimal cerebral perfusion pressure (CPPopt) can be calculated, i.e., the level of CPP where autoregulation functions best. The relation between cerebral blood flow (CBF) and CPPopt has not been examined. The objective was to assess to which extent CPPopt can be calculated in SAH patients and to investigate CPPopt in relation to CBF.
methodsRetrospective study of prospectively collected data. CBF was measured bedside with Xenon-enhanced CT (Xe-CT). The difference between actual CPP and CPPopt was calculated (CPP∆). Correlations between CPP∆ and CBF parameters were calculated with Spearman's rank order correlation coefficient (rho). Separate calculations were done using all patients (day 0-14 after onset) as well as in two subgroups (day 0-3 and day 4-14).
resultsEighty-two patients with 145 Xe-CT scans were studied. Automated calculation of CPPopt was possible in adjunct to 60% of the Xe-CT scans. Actual CPP < CPPopt was associated with higher numbers of low-flow regions (CBF <10 ml/100 g/min) in both the early phase (day 0-3, n = 39, Spearman's rho = -0.38, p = 0.02) and late acute phase of the disease (day 4-14, n = 35, Spearman's rho = -0.39, p = 0.02). CPP level per se was not associated with CBF.
conclusionsCalculation of CPPopt is possible in a majority of patients with severe SAH. Actual CPP below CPPopt is associated with low CBF.
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