Perioperative Changes of Cerebrovascular Autoregulation and Association With Cognitive Function

Universitätsklinikum Hamburg-Eppendorf

Status

Terminated

Conditions

Surgery

Cognitive Function Abnormal

Anesthesia

Study type

Observational

Funder types

Other

Identifiers

NCT04101006

PV4771

Details and patient eligibility

About

Cerebral blood flow is tightly regulated to ensure constant cerebral perfusion independently from systemic blood pressure fluctuations. This mechanism is termed cerebrovascular autoregulation and preserves adequate cerebral perfusion in a range between 50 and 150 mmHg of cerebral perfusion pressure. Upper and lower autoregulatory limits may vary individually. Beyond the autoregulatory range the protective autoregulatory response is lost, facilitating cerebral ischemia or hyperemia.

The cerebrovascular response may be altered during general anesthesia, through direct effects of anesthetic agents on the vascular tone, changes of arterial partial pressure of carbon dioxide or the administration of vasoactive substances. The association of perioperative impairment of cerebral autoregulation and postoperative cognitive function has been discussed controversially.

Full description

continuous monitoring of cerebrovascular autoregulation using the correlation method
based on near-infrared spectroscopy and invasive blood pressure measurement an index (COx) will be calculated
autoregulation monitoring from anesthesia induction until emergence from anesthesia
assessment of preoperative cognitive function during preanesthesia evaluation or on the day before surgery
assessment of postoperative cognitive function between day 3 and 14 following surgery
evaluation of subjective cognitive complaints or attention deficits 3 months after surgery

Enrollment

78 patients

Sex

All

Ages

60+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria