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Titolo:
CEREBRAL HEMODYNAMICS DURING CARDIOVERTER -DEFIBRILLATOR IMPLANTATION
Autore:
DOERING TJ; TRAPPE HJ; PANNING B; FIEGUTH HG; STEUERNAGEL B; SCHNEIDER B; PIEPENBROCK S; FISCHER GC;
Indirizzi:
HANNOVER MED SCH,ABT ALLGEMEINMED,CARL NEUBERG STR 1 D-30625 HANNOVERGERMANY RUHR UNIV BOCHUM,KLIN MARIENHOSP,MED KLIN 1 BOCHUM GERMANY
Titolo Testata:
Medizinische Klinik
fascicolo: 5, volume: 93, anno: 1998,
pagine: 279 - 283
SICI:
0723-5003(1998)93:5<279:CHDC-I>2.0.ZU;2-I
Fonte:
ISI
Lingua:
GER
Soggetto:
BRAIN;
Keywords:
IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD); TRANSCRANIAL DOPPLER SONOGRAPHY (TCD); CEREBRAL HEMODYNAMICS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
T.J. Doering et al., "CEREBRAL HEMODYNAMICS DURING CARDIOVERTER -DEFIBRILLATOR IMPLANTATION", Medizinische Klinik, 93(5), 1998, pp. 279-283

Abstract

Objective: During ICD-implantation it is necessary to prove the function and to determine the optimal threshold by means of induced ventricular fibrillation (VF). Provoked cardiac arrests cause a circulatory stop of the cerebral perfusion. Our aim was to examine the changes of cerebral blood now velocity (CBFV(MCA)) after induced VF depending on the duration of fibrillation and prior values of CBFV(MCA). Patients and Methods: Sixty induced episodes of VF in 9 patients (mean age +/- SD53.5 +/- 8 years) were examined during ICD-implantation. Beside the standardized anaesthesiological monitoring, transcranial Doppler sonography was used to record the cerebral blood flow velocity in the middlecerebri artery CBFV(MCA). The duration of the fibrillation-period andthe range and duration of the CBFV increase during the post defibrillation-period were correlated. Additionally, we examined whether systematic differences existed between the episodes of each patient(time-trend) by means of 5 following episodes of a patient. Results: During allepisodes of VF a hyperperfusion was present, that means a time intervall showing increased values of CBFV(MCA), compared to the values present before VF. The duration of hyperperfusion depended significantly on die fibrillation time (r = 0,57; p < 0,001). The equation of regression is: hyperperfusion time = 11,1 + 1,22 x fibrillation time. The amount of hyperperfusion, that means the maximal CBFV after dt fibrillation, increased significantly with CBFV(MCA) before VF (correlation = 0,88; p < 0,001). The equation of regression is: hyperperfusion height =6,11 + 1,22 x CBFV(MCA) before VF. The duration of hyperperfusion is not influenced by the maximal CBFV(MCA)) after defibrillation (r = 0,08; p = 0,52). In the examined patients no significant differences in the hyperperfusion time and maximal CBFV(MCA) after defibrillation between the episodes were found. Conclusion: After induced VF you always have to respect a reactive cerebral hyperperfusion, The amount of increase of CBFV after defibrillation depends on the prior values of CBFV before fibrillation and shows 3 nearly proportional relation to these. The duration of hyperperfusion shows a linear dependency on VF-times. This may show that we had VF-times, in which the cerebral autoregulation and other cerebral physiological reactions compensate the drop of the CBFV(MCA) during VF in the postfibrillation time. In further studies will be examined if there are similar changes in the cerebral metabolism as in CBFV(MCA).

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 06:17:58