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Anesthesia Medication Effects on Cerebral Hemodynamics

Anesthesia Medication Effects on Cerebral Hemodynamics. Site of autoregulation. Site of autoregulation Site of medication effects. Site of autoregulation Site of medication effects. D ifficult to measure. Site of autoregulation Site of medication effects. D ifficult to measure

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Anesthesia Medication Effects on Cerebral Hemodynamics

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  1. Anesthesia Medication Effects on Cerebral Hemodynamics

  2. Site of autoregulation

  3. Site of autoregulation • Site of medication effects

  4. Site of autoregulation • Site of medication effects Difficult to measure

  5. Site of autoregulation • Site of medication effects Difficult to measure Varies to a lesser degree than CBF

  6. Site of autoregulation • Site of medication effects Difficult to measure Varies to a lesser degree than CBF CSF, CBV, Brain Tissue

  7. Site of autoregulation • Site of medication effects Difficult to measure Varies to a lesser degree than CBF CSF, CBV, Brain Tissue Focal vs global Affects all above variables

  8. MAP- ICP _____________ Resistance

  9. MAP- ICP Directly Proportional _____________ Resistance

  10. MAP- ICP Directly Proportional _____________ Resistance Inversely proportional

  11. Normal Values:

  12. Normal Values: 15-20% of CO

  13. Normal Values: 15-20% of CO 750 mL/min

  14. Normal Values: 15-20% of CO 750 mL/min 50 mL/100g/min

  15. Normal Variation:

  16. Normal Variation: BP above autoregulation range CBF

  17. Normal Variation: BP above autoregulation range CBF BP below autoregulation range CBF

  18. Questions

  19. Answers • Question #1: A) Brain Tissue • The 3 components that make up ICP are brain tissue, CSF, and CBV. Brain tissue accounts for 80% of ICP while CSF and CBV account for 10% each.

  20. Answers • Question #2: B) Blood flow of 50 ml/min/100 g of tissue • Normal ICP is <15 and the brain normally receives 15-20% of cardiac output. The typical total blood flow to the brain is 750 ml/min or 50 ml/min/100 g of tissue. Cerebral Ischemia begins when blood flow drops below 20 and infarct begins at 6 ml/min/100 g of tissue.

  21. Answers • Question #3: C) Increased cerebral vascular resistance • Hypercarbia and hypoxia both would increase CBF due to increased metabolic demand. Increased cerebral vascular resistance would have an inverse effect on CBF.

  22. MAP 50-150

  23. MAP 50-150 Rapid change will still affect CBF

  24. MAP 50-150 Rapid change will still affect CBF Disrupted by : volatile anesthetics

  25. MAP 50-150 Rapid change will still affect CBF Disrupted by : volatile anesthetics HTN

  26. MAP 50-150 Rapid change will still affect CBF Disrupted by : volatile anesthetics HTN

  27. Pt’s Baseline MAPdetermines the patient’s autoregulation range

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