• Anesthesia and analgesia · Oct 2022

    Pro-Con Debate: The Clinical (Ir)relevance of the Lower Limit of Cerebral Autoregulation for Anesthesiologists.

    • Marek Czosnyka, Thomas Santarius, Joseph Donnelly, Rokus E C van den Dool, and Nicolaas H Sperna Weiland.
    • From the Division of Neurosurgery, Cambridge University Hospitals, Cambridge, United Kingdom.
    • Anesth. Analg. 2022 Oct 1; 135 (4): 734-743.

    AbstractIn this Pro-Con commentary article, we discuss whether the lower limit of cerebral autoregulation is clinically relevant for anesthesiologists. The central question regarding this issue is whether mean arterial blood pressure below the lower limit of autoregulation is detrimental for the brain. The Pro side argues that continuous monitoring of cerebral autoregulation has revealed an association between going below the lower limit and mortality in the critically ill patient. Conversely, the Con side argues that cerebral autoregulation is only one of various defense mechanisms of the brain that protect against cerebral hypoperfusion, and that cerebral autoregulation may be more important to protect against intracranial hypertension.Copyright © 2022 International Anesthesia Research Society.

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