TY - JOUR
T1 - Pro-Con Debate
T2 - The Clinical (Ir)relevance of the Lower Limit of Cerebral Autoregulation for Anesthesiologists
AU - Czosnyka, Marek
AU - Santarius, Thomas
AU - Donnelly, Joseph
AU - van den Dool, Rokus E. C.
AU - Sperna Weiland, Nicolaas H.
N1 - Funding Information: Conflicts of Interest: M. Czosnyka has a financial interest in part of the licensing fee for ICM+ (Intensive Care Monitoring) software (Cambridge Enterprise Ltd, UK). He was supported by the National Institute for Health and Care Research, Cambridge Biomedical Research Centre. Publisher Copyright: © 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - In this Pro-Con commentary article, we discuss whether the lower limit of cerebral autoregulation is clinically relevant for anesthesiologists. The central question regarding this issue is whether mean arterial blood pressure below the lower limit of autoregulation is detrimental for the brain. The Pro side argues that continuous monitoring of cerebral autoregulation has revealed an association between going below the lower limit and mortality in the critically ill patient. Conversely, the Con side argues that cerebral autoregulation is only one of various defense mechanisms of the brain that protect against cerebral hypoperfusion, and that cerebral autoregulation may be more important to protect against intracranial hypertension.
AB - In this Pro-Con commentary article, we discuss whether the lower limit of cerebral autoregulation is clinically relevant for anesthesiologists. The central question regarding this issue is whether mean arterial blood pressure below the lower limit of autoregulation is detrimental for the brain. The Pro side argues that continuous monitoring of cerebral autoregulation has revealed an association between going below the lower limit and mortality in the critically ill patient. Conversely, the Con side argues that cerebral autoregulation is only one of various defense mechanisms of the brain that protect against cerebral hypoperfusion, and that cerebral autoregulation may be more important to protect against intracranial hypertension.
UR - http://www.scopus.com/inward/record.url?scp=85137899441&partnerID=8YFLogxK
U2 - https://doi.org/10.1213/ANE.0000000000006123
DO - https://doi.org/10.1213/ANE.0000000000006123
M3 - Article
C2 - 36108190
SN - 0003-2999
VL - 135
SP - 734
EP - 743
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 4
ER -