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dc.contributor.authorCrippa, Ilaria Alice
dc.contributor.authorSubirà Cuyàs, Carles
dc.contributor.authorVincent, Jean-Louis
dc.contributor.authorFernández Fernández, Rafael
dc.contributor.authorCano Hernandez, Silvia
dc.contributor.authorZama Cavicchi, Federica
dc.contributor.authorCreteur, Jacques
dc.contributor.authorTaccone, Fabio Silvio
dc.date.accessioned2019-12-23T16:33:56Z
dc.date.available2019-12-23T16:33:56Z
dc.date.issued2018-12-04
dc.identifier.citationCrippa, Ilaria Alice; Subirà, Carles; Vincent, Jean-Louis [et al.]. Impaired cerebral autoregulation is associated with brain dysfunction in patients with sepsis. Critical Care, 2018, vol. 22, p. 1-9. Disponible en: <https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2258-8#rightslink>. Fecha de acceso: 23 dic. 2019. DOI: 10.1186/s13054-018-2258-8ca
dc.identifier.issn1364-8535ca
dc.identifier.urihttp://hdl.handle.net/20.500.12328/1407
dc.description.abstractBackground: Sepsis-associated brain dysfunction (SABD) is associated with high morbidity and mortality. The pathophysiology of SABD is multifactorial. One hypothesis is that impaired cerebral autoregulation (CAR) may result in brain hypoperfusion and neuronal damage leading to SABD. Methods: We studied 100 adult patients with sepsis (July 2012–March 2017) (age = 62 [52–71] years; Acute Physiology and Chronic Health Evaluation II score on admission = 21 [15–26]). Exclusion criteria were acute or chronic intracranial disease, arrhythmias, extracorporeal membrane oxygenation, and known intra- or extracranial supra-aortic vessel disease. The site of infection was predominantly abdominal (46%) or pulmonary (28%). Transcranial Doppler was performed, insonating the left middle cerebral artery with a 2-MHz probe. Middle cerebral artery blood flow velocity (FV) and arterial blood pressure (ABP) signals were recorded simultaneously; Pearson’s correlation coefficient (mean flow index [Mxa]) between ABP and FV was calculated using MATLAB. Impaired CAR was defined as Mxa > 0.3. Results: Mxa was 0.29 [0.05–0.62]. CAR was impaired in 50 patients (50%). In a multiple linear regression analysis, low mean arterial pressure, history of chronic kidney disease and fungal infection were associated with high Mxa. SABD was diagnosed in 57 patients (57%). In a multivariable analysis, altered cerebral autoregulation, mechanical ventilation and history of vascular disease were independent predictors of SABD. Conclusions: Cerebral autoregulation was altered in half of the patients with sepsis and was associated with the development of SABD. These findings support the concept that cerebral hypoxia could contribute to the development of SABD.ca
dc.format.extent9ca
dc.language.isoengca
dc.publisherSpringer Natureca
dc.relation.ispartofCritical Careca
dc.relation.ispartofseries22;
dc.rightsThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.ca
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject.otherCervell -- Degeneracióca
dc.subject.otherCirculació cerebralca
dc.subject.otherEcoencefalografiaca
dc.subject.otherCerebro -- Disfunción
dc.subject.otherCirculación cerebrovascular
dc.subject.otherEcoencefalografía
dc.subject.otherCerebrovascular circulation
dc.subject.otherCerebral blood flow
dc.subject.otherBrain dysfunction
dc.titleImpaired cerebral autoregulation is associated with brain dysfunction in patients with sepsisca
dc.typeinfo:eu-repo/semantics/articleca
dc.description.versioninfo:eu-repo/semantics/acceptedVersionca
dc.embargo.termscapca
dc.subject.udc61ca
dc.identifier.doihttps://dx.doi.org/10.1186/s13054-018-2258-8ca


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This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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