Cerebral autoregulation after aneurysmal subarachnoid haemorrhage. A preliminary study comparing dexmedetomidine to propofol and/or midazolam

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dc.contributor.author Kallioinen, Minna
dc.contributor.author Posti, Jussi P.
dc.contributor.author Rahi, Melissa
dc.contributor.author Sharma, Deepak
dc.contributor.author Katila, Ari
dc.contributor.author Grönlund, Juha
dc.contributor.author Vahlberg, Tero
dc.contributor.author Frantzén, Janek
dc.contributor.author Olkkola, Klaus T.
dc.contributor.author Saari, Teijo I.
dc.contributor.author Takala, Riikka
dc.date.accessioned 2021-06-30T22:22:59Z
dc.date.available 2021-06-30T22:22:59Z
dc.date.issued 2020-10
dc.identifier.citation Kallioinen , M , Posti , J P , Rahi , M , Sharma , D , Katila , A , Grönlund , J , Vahlberg , T , Frantzén , J , Olkkola , K T , Saari , T I & Takala , R 2020 , ' Cerebral autoregulation after aneurysmal subarachnoid haemorrhage. A preliminary study comparing dexmedetomidine to propofol and/or midazolam ' , Acta Anaesthesiologica Scandinavica , vol. 64 , no. 9 , pp. 1278-1286 . https://doi.org/10.1111/aas.13663
dc.identifier.other PURE: 140268931
dc.identifier.other PURE UUID: 5971f642-7e06-4ea2-997c-829de96122ed
dc.identifier.other RIS: urn:6DF64BBBE212569EC24F89F374F24075
dc.identifier.other WOS: 000549722700001
dc.identifier.other ORCID: /0000-0001-7872-8665/work/80945895
dc.identifier.uri http://hdl.handle.net/10138/332074
dc.description.abstract Abstract Background Cerebral autoregulation is often impaired after aneurysmal subarachnoid haemorrhage (aSAH). Dexmedetomidine is being increasingly used, but its effects on cerebral autoregulation in patients with aSAH have not been studied before. Dexmedetomidine could be a useful sedative in patients with aSAH as it enables neurological assessment during the infusion. The aim of this preliminary study was to compare the effects of dexmedetomidine on dynamic and static cerebral autoregulation with propofol and/or midazolam in patients with aSAH. Methods Ten patients were recruited. Dynamic and static cerebral autoregulation were assessed using transcranial Doppler ultrasound during propofol and/or midazolam infusion and then during three increasing doses of dexmedetomidine infusion (0.7, 1.0 and 1.4 µg/kg/h). Transient hyperaemic response ratio (THRR) and strength of autoregulation (SA) were calculated to assess dynamic cerebral autoregulation. Static rate of autoregulation (sRoR)% was calculated by using noradrenaline infusion to increase the mean arterial pressure 20 mmHg above the baseline. Results Data from 9 patients were analysed. Compared to baseline, we found no statistically significant changes in THRR or sROR%. THRR was (mean±SD) 1.20 ±0.14, 1.17±0.13(p=0.93), 1.14±0.09 (p=0.72) and 1.19±0.18 (p=1.0) and sROR% was 150.89±84.37, 75.22±27.75 (p=0.08), 128.25±58.35 (p=0.84) and 104.82±36.92 (p=0.42) at baseline and during 0.7, 1.0 and 1.4 µg/kg/h dexmedetomidine infusion, respectively. Dynamic SA was significantly reduced after 1.0 µg/kg/h dexmedetomidine (p=0.02). Conclusions Compared to propofol and/or midazolam, dexmedetomidine did not alter static cerebral autoregulation in aSAH patients, whereas a significant change was observed in dynamic SA. Further and larger studies with dexmedetomidine in aSAH patients are warranted. en
dc.format.extent 9
dc.language.iso eng
dc.relation.ispartof Acta Anaesthesiologica Scandinavica
dc.rights unspecified
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.subject TRANSIENT HYPEREMIC RESPONSE
dc.subject CEREBROVASCULAR AUTOREGULATION
dc.subject BLOOD-FLOW
dc.subject PRESSURE AUTOREGULATION
dc.subject STATIC AUTOREGULATION
dc.subject CARBON-DIOXIDE
dc.subject HEMORRHAGE
dc.subject IMPAIRMENT
dc.subject ISCHEMIA
dc.subject SEDATION
dc.title Cerebral autoregulation after aneurysmal subarachnoid haemorrhage. A preliminary study comparing dexmedetomidine to propofol and/or midazolam en
dc.type Article
dc.contributor.organization HUS Perioperative, Intensive Care and Pain Medicine
dc.contributor.organization Department of Diagnostics and Therapeutics
dc.contributor.organization University of Helsinki
dc.contributor.organization Helsinki University Hospital Area
dc.contributor.organization Anestesiologian yksikkö
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1111/aas.13663
dc.relation.issn 0001-5172
dc.rights.accesslevel openAccess
dc.type.version acceptedVersion

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