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