Static autoregulation in humans: a review and reanalysis

Tianne Numan; Anthony R. Bain; Ryan L. Hoiland; Jonathan D. Smirl; Nia C. Lewis; Philip N. Ainslie

doi:10.1016/j.medengphy.2014.08.001

Static autoregulation in humans: a review and reanalysis

Tianne Numan, Anthony R. Bain, Ryan L. Hoiland, Jonathan D. Smirl, Nia C. Lewis, Philip N. Ainslie

Research output: Contribution to journal › Article › peer-review

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Abstract

INTRODUCTION: Cerebral autoregulation (CA) is a theoretical construct characterized by the relationship between mean arterial pressure (MAP) and cerebral blood flow (CBF). We performed a comprehensive literature search to provide an up-to-date review on the static relationship between MAP and CBF.

METHODS: The results are based on 40 studies (49 individual experimental protocols) in healthy subjects between 18 and 65 years. Exclusion criteria were: a ΔMAP <5%, hypoxia/hyperoxia or hypo/hypercapnia, and unstable levels (<2 min stages). The partial pressure of arterial CO2 (PaCO2) was measured in a subset of the included studies (n=28); therefore, CBF was also adjusted to account for small changes in PaCO2.

RESULTS: The linear regression coefficient between MAP and CBF (or velocity) of 0.82±0.77%ΔCBF/%ΔMAP during decreases in MAP (n=23 experiments) was significantly different than the relationship of 0.21±0.47%ΔCBF/%ΔMAP during increases (n=26 experiments; p<0.001). After correction for increases/decreases in PaCO2, the slopes were not significantly different: 0.64±1.16%ΔCBF/%ΔMAP (n=16) and 0.39±0.30%ΔCBF/%ΔMAP (n=12) for increased vs. decreased MAP changes, respectively (p=0.60).

CONCLUSION: The autoregulatory ability of the cerebral circulation appears to be more active in buffering increases in MAP as compared to reductions in MAP. However, the statistical finding of hysteresis is lost following an attempt to correct for PaCO2.

Original language	English
Pages (from-to)	1487-1495
Number of pages	9
Journal	Medical engineering & physics
Volume	36
Issue number	11
DOIs	https://doi.org/10.1016/j.medengphy.2014.08.001
Publication status	Published - 1 Nov 2014

Keywords

Blood pressure
Cerebral autoregulation
Cerebral blood flow
Cerebrovascular CO(2) reactivity

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10.1016/j.medengphy.2014.08.001Licence: CC BY-NC-ND

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title = "Static autoregulation in humans: a review and reanalysis",

abstract = "INTRODUCTION: Cerebral autoregulation (CA) is a theoretical construct characterized by the relationship between mean arterial pressure (MAP) and cerebral blood flow (CBF). We performed a comprehensive literature search to provide an up-to-date review on the static relationship between MAP and CBF.METHODS: The results are based on 40 studies (49 individual experimental protocols) in healthy subjects between 18 and 65 years. Exclusion criteria were: a ΔMAP <5%, hypoxia/hyperoxia or hypo/hypercapnia, and unstable levels (<2 min stages). The partial pressure of arterial CO2 (PaCO2) was measured in a subset of the included studies (n=28); therefore, CBF was also adjusted to account for small changes in PaCO2.RESULTS: The linear regression coefficient between MAP and CBF (or velocity) of 0.82±0.77%ΔCBF/%ΔMAP during decreases in MAP (n=23 experiments) was significantly different than the relationship of 0.21±0.47%ΔCBF/%ΔMAP during increases (n=26 experiments; p<0.001). After correction for increases/decreases in PaCO2, the slopes were not significantly different: 0.64±1.16%ΔCBF/%ΔMAP (n=16) and 0.39±0.30%ΔCBF/%ΔMAP (n=12) for increased vs. decreased MAP changes, respectively (p=0.60).CONCLUSION: The autoregulatory ability of the cerebral circulation appears to be more active in buffering increases in MAP as compared to reductions in MAP. However, the statistical finding of hysteresis is lost following an attempt to correct for PaCO2.",

keywords = "Blood pressure, Cerebral autoregulation, Cerebral blood flow, Cerebrovascular CO(2) reactivity",

author = "Tianne Numan and Bain, {Anthony R.} and Hoiland, {Ryan L.} and Smirl, {Jonathan D.} and Lewis, {Nia C.} and Ainslie, {Philip N.}",

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T2 - a review and reanalysis

AU - Numan, Tianne

AU - Bain, Anthony R.

AU - Hoiland, Ryan L.

AU - Smirl, Jonathan D.

AU - Lewis, Nia C.

AU - Ainslie, Philip N.

PY - 2014/11/1

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N2 - INTRODUCTION: Cerebral autoregulation (CA) is a theoretical construct characterized by the relationship between mean arterial pressure (MAP) and cerebral blood flow (CBF). We performed a comprehensive literature search to provide an up-to-date review on the static relationship between MAP and CBF.METHODS: The results are based on 40 studies (49 individual experimental protocols) in healthy subjects between 18 and 65 years. Exclusion criteria were: a ΔMAP <5%, hypoxia/hyperoxia or hypo/hypercapnia, and unstable levels (<2 min stages). The partial pressure of arterial CO2 (PaCO2) was measured in a subset of the included studies (n=28); therefore, CBF was also adjusted to account for small changes in PaCO2.RESULTS: The linear regression coefficient between MAP and CBF (or velocity) of 0.82±0.77%ΔCBF/%ΔMAP during decreases in MAP (n=23 experiments) was significantly different than the relationship of 0.21±0.47%ΔCBF/%ΔMAP during increases (n=26 experiments; p<0.001). After correction for increases/decreases in PaCO2, the slopes were not significantly different: 0.64±1.16%ΔCBF/%ΔMAP (n=16) and 0.39±0.30%ΔCBF/%ΔMAP (n=12) for increased vs. decreased MAP changes, respectively (p=0.60).CONCLUSION: The autoregulatory ability of the cerebral circulation appears to be more active in buffering increases in MAP as compared to reductions in MAP. However, the statistical finding of hysteresis is lost following an attempt to correct for PaCO2.

AB - INTRODUCTION: Cerebral autoregulation (CA) is a theoretical construct characterized by the relationship between mean arterial pressure (MAP) and cerebral blood flow (CBF). We performed a comprehensive literature search to provide an up-to-date review on the static relationship between MAP and CBF.METHODS: The results are based on 40 studies (49 individual experimental protocols) in healthy subjects between 18 and 65 years. Exclusion criteria were: a ΔMAP <5%, hypoxia/hyperoxia or hypo/hypercapnia, and unstable levels (<2 min stages). The partial pressure of arterial CO2 (PaCO2) was measured in a subset of the included studies (n=28); therefore, CBF was also adjusted to account for small changes in PaCO2.RESULTS: The linear regression coefficient between MAP and CBF (or velocity) of 0.82±0.77%ΔCBF/%ΔMAP during decreases in MAP (n=23 experiments) was significantly different than the relationship of 0.21±0.47%ΔCBF/%ΔMAP during increases (n=26 experiments; p<0.001). After correction for increases/decreases in PaCO2, the slopes were not significantly different: 0.64±1.16%ΔCBF/%ΔMAP (n=16) and 0.39±0.30%ΔCBF/%ΔMAP (n=12) for increased vs. decreased MAP changes, respectively (p=0.60).CONCLUSION: The autoregulatory ability of the cerebral circulation appears to be more active in buffering increases in MAP as compared to reductions in MAP. However, the statistical finding of hysteresis is lost following an attempt to correct for PaCO2.

KW - Blood pressure

KW - Cerebral autoregulation

KW - Cerebral blood flow

KW - Cerebrovascular CO(2) reactivity

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DO - 10.1016/j.medengphy.2014.08.001

M3 - Article

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VL - 36

SP - 1487

EP - 1495

JO - Medical Engineering and Physics

JF - Medical Engineering and Physics

SN - 1350-4533

IS - 11

ER -

Static autoregulation in humans: a review and reanalysis

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