脑卒中急性期动态脑自动调节及其与临床预后关系的研究综述。

Ricardo C Nogueira, Marcel Aries, Jatinder S Minhas, Nils H Petersen, Li Xiong, Jana M Kainerstorfer, Pedro Castro
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引用次数: 22

摘要

急性中风的发病率和死亡率都很高。在过去的几十年里,研究了新的治疗方法,目的是改善中风发作后急性期的临床结果。然而,尽管取得了这些进展,许多患者并没有表现出改善,而且,一些患者不幸恶化。因此,有必要针对个别患者进行额外的治疗。一个潜在的治疗目标是通过脑血流动力学参数如动态脑自动调节(dCA)来优化脑灌注。这种叙述导致了INFOMATAS(确定急性卒中管理和治疗的新目标)项目的发展,旨在促进干预措施,以了解和改善急性脑血管疾病状态下脑循环的血液动力学方面。本文综述了急性缺血性脑卒中、脑出血和蛛网膜下腔出血患者dCA评估的相关研究。这篇综述将向读者提供最一致的发现,不一致的发现仍需要进一步探索,并讨论这些研究的主要局限性。这将允许创建一个研究议程,使用床边dCA信息进行预测和靶向灌注干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Review of studies on dynamic cerebral autoregulation in the acute phase of stroke and the relationship with clinical outcome.

Review of studies on dynamic cerebral autoregulation in the acute phase of stroke and the relationship with clinical outcome.

Acute stroke is associated with high morbidity and mortality. In the last decades, new therapies have been investigated with the aim of improving clinical outcomes in the acute phase post stroke onset. However, despite such advances, a large number of patients do not demonstrate improvement, furthermore, some unfortunately deteriorate. Thus, there is a need for additional treatments targeted to the individual patient. A potential therapeutic target is interventions to optimize cerebral perfusion guided by cerebral hemodynamic parameters such as dynamic cerebral autoregulation (dCA). This narrative led to the development of the INFOMATAS (Identifying New targets FOr Management And Therapy in Acute Stroke) project, designed to foster interventions directed towards understanding and improving hemodynamic aspects of the cerebral circulation in acute cerebrovascular disease states. This comprehensive review aims to summarize relevant studies on assessing dCA in patients suffering acute ischemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage. The review will provide to the reader the most consistent findings, the inconsistent findings which still need to be explored further and discuss the main limitations of these studies. This will allow for the creation of a research agenda for the use of bedside dCA information for prognostication and targeted perfusion interventions.

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