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Cited by 150Traumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury ResearchHemodynamic Monitoring and Therapy

Monitoring of autoregulation using laser Doppler flowmetry in patients with head injury

Lam, Joseph M. K., Hsiang, John N. K., Poon, Wai S.·1997·Journal of Neurosurgery
DOI 10.3171/jns.1997.86.3.0438
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Abstract

✓ The authors studied 31 comatose head-injured patients to assess the clinical usefulness of laser Doppler flowmetry (LDF) in continuous autoregulation monitoring. The LDF probes were placed on the surface of the cerebral cortex. Data on LDF, intracranial pressure (ICP), and arterial blood pressure (ABP) were recorded and continuously entered into a computer. The data were broken down into multiple segments of 15 minutes' duration (epochs). Epochs showing rapid change in cerebral perfusion pressure (CPP), change in CPP of less than 10 mm Hg, LDF values of less than five arbitrary units, and loss of ABP/ICP waveform were excluded from further analysis. A linear relationship between LDF and CPP in individual epochs was used as an indicator of loss of autoregulation. The relationship between LDF and CPP changed with time, indicating improvement or deterioration in autoregulation. Longitudinal analysis of all the epochs measured in a patient revealed three patterns of progress: 1) intact autoregulation; 2) transient loss; and 3) persistent loss of autoregulation. All five patients with intact autoregulation had a good outcome. Ten patients experienced transient loss of autoregulation; of these four had a good outcome, five were moderately disabled, and one was severely disabled. Transient impairment of autoregulation did not always indicate poor outcome, provided the impaired autoregulation responded to treatment. In 11 patients who had persistent loss of autoregulation, nine died and two were severely disabled. In five cases the LDF probe lost contact with the cerebral cortex and no useful information was obtained. Real-time measurement of autoregulation using LDF and CPP monitors was achieved and the findings were related to outcome in these patients.

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Crossref · 10.3171/jns.1997.86.3.0438

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  • Second-impact syndrome is thought to result from abrupt post-traumatic loss of cerebral blood flow autoregulation and catecholamine release that create a rapid increase in intracranial blood volume and catastrophic cerebral edema.

    “SIS is thought to result from abrupt post-traumatic loss of cerebral blood flow autoregulation and catecholamine release that create a rapid increase in intracranial blood volume and catastrophic cerebral edema [32, 105].”

    From The neuropathology of sport (2014) · cites this paper as [105]

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Related

Authors
Lam, J. M. K., Hsiang, J. N. K., & Poon, W. S.
Affiliations
Chinese University of Hong Kong (HK)
ORCID
Poon, Wai S.
Venue
Journal of Neurosurgery
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Published
1997-03
Volume
86
Issue
3
Pages
438-445
ISSN
0022-3085 (ISSN-L)
DOI
10.3171/jns.1997.86.3.0438
OpenAlex
W2062965541
Cited by
150
References
29
Citations by year
2025: 3 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 2 · 2018: 5 · 2017: 14 · 2016: 5 · 2015: 7 · 2014: 4 · 2013: 6 · 2012: 7
FWCI
4.52
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of neurosurgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
Keywords
cerebral autoregulation, laser Doppler flowmetry, traumatic brain injury, coma, cerebral perfusion pressure, intracranial pressure, arterial blood pressure, outcome prediction, real-time monitoring
MeSH terms
Adult, Aged, Blood Pressure, Brain Injuries, Cerebral Cortex, Cerebral Hemorrhage, Cerebrovascular Circulation, Child, Child, Preschool, Coma, Female, Follow-Up Studies, Disabled Persons, Persons with Disabilities, Homeostasis, Humans, Intracranial Pressure, Jugular Veins, Longitudinal Studies, Male, Middle Aged, Monitoring, Physiologic, Oxygen, Signal Processing, Computer-Assisted, Survival Rate, Treatment Outcome, Laser-Doppler Flowmetry

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