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Risks for impaired cerebral autoregulation during cardiopulmonary bypass and postoperative stroke
M. Ono, B. Joshi, K. Brady, R.B. Easley, Y. Zheng, C. Brown, W. Baumgartner, C.W. Hogue British Journal of Anaesthesia Volume 109, Issue 3, Pages (September 2012) DOI: /bja/aes148 Copyright © 2012 The Author(s) Terms and Conditions
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Fig 1 Monitoring results from a patient with (a) intact CBF autoregulation and (b) impaired CBF autoregulation during CPB. In a and b, the top graph is MAP, and the middle two graphs are the mean velocity index (Mx) for the right and left brain hemispheres. The bottom graph is the percentage of time during the recording at each 5 mm Hg bin of arterial pressure. When arterial pressure is within the autoregulation range, Mx approaches zero. When arterial pressure is outside the autoregulatory range, Mx increases toward 1 as CBF and arterial pressure become correlated. Using an Mx cut-off of ≥0.40, arterial pressure of the patient shown in (a) approaches the lower limit of autoregulation at around 75 mm Hg, while the upper limit of autoregulation is approached at an MAP of 100 mm Hg. In contrast, the patient in (b) demonstrates impaired autoregulation at all arterial pressure readings. British Journal of Anaesthesia , DOI: ( /bja/aes148) Copyright © 2012 The Author(s) Terms and Conditions
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