Journal CME - 2017 June
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Journal CME - 2017 June

Journal CME - 2017 June


This comprehensive review summarizes the evidence regarding use of cerebral autoregulation-directed therapy at the bedside and provides an evaluation of its impact on optimizing cerebral perfusion and associated functional outcomes. Multiple studies in adults and several in children have shown the feasibility of individualizing mean arterial blood pressure and cerebral perfusion pressure goals by using cerebral autoregulation monitoring to calculate optimal levels. Nine of these studies examined the association between cerebral perfusion pressure or mean arterial blood pressure being above or below their optimal levels and functional outcomes. Six of these nine studies (66%) showed that patients for whom median cerebral perfusion pressure or mean arterial blood pressure differed significantly from the optimum, defined by cerebral autoregulation monitoring, were more likely to have an unfavorable outcome. The evidence indicates that monitoring of continuous cerebral autoregulation at the bedside is feasible and has the potential to be used to direct blood pressure management in acutely ill patients.

CME Credit: 1.00 AMA PRA Category 1 Credit

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Learning Objectives:
After successfully completing this activity, the learner will be able to do the following:

- Recognize that maintenance of the same mean arterial pressure (MAP) or cerebral perfusion pressure may not be optimal for all patients
- Describe the physiologic mechanisms involved in...

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