British Journal of Anaesthesia, Vol 81, Issue 3 317-321, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
G. Cavill, E. J. Simpson and R. P. Mahajan
The transient hyperaemic response in the middle cerebral artery blood flow
velocity on the release of brief compression of the ipsilateral common
carotid artery has been validated as an indicator of cerebral
autoregulation. We evaluated, in three stages, the effect of experimental
factors such as duration of compression of the common carotid artery and
magnitude of the decrease in blood flow velocity during common carotid
artery compression on the transient hyperaemic response. In stage 1, 13
healthy volunteers underwent six transient hyperaemic response tests each;
two tests each for either 3, 6 or 10 s duration of compression of the
common carotid artery. In stage 2, 10 volunteers underwent four transient
hyperaemic response tests each; two tests each for either 10 or 15 s
duration of compression of the common carotid artery. In stage 3, data from
the transient hyperaemic response tests using 10 s compression from the 23
volunteers who participated in stages 1 and 2 were analysed to evaluate the
relationship between magnitude of decrease in blood flow velocity at the
onset of compression and the transient hyperaemic response. The transient
hyperaemic response ratio (blood flow velocity after the release of
compression/baseline blood flow velocity) increased significantly when the
duration of common carotid artery compression increased from 3 to 6 s, or
from 6 to 10 s (stage 1); increase in the duration from 10 to 15 s did not
have any significant effect (stage 2). The transient hyperaemic response
ratio correlated significantly with the magnitude of decrease in blood flow
velocity after compression, up to the values of the compression ratio
(percent decrease in blood flow velocity at the onset of compression) of
40% but not more (stage 3). We conclude that experimental factors such as
duration of common carotid artery compression and magnitude of the decrease
in blood flow velocity during common carotid artery compression can
significantly influence the transient hyperaemic response. These factors
should be controlled if the transient hyperaemic response test is used for
a comparison between repeated measurements. A compression time of 10 s and
a compression ratio of 40% or more, allow maximum expression of the
hyperaemic response in healthy volunteers.
CLINICAL INVESTIGATIONS
Factors affecting assessment of cerebral autoregulation using the transient hyperaemic response test
University Department of Anaesthesia, Queen's Medical Centre and City Hospital NHS Trust, Nottingham NG7 2UH; Department of Physiology and Pharmacology, Queen's Medical Centre and City Hospital NHS Trust, Nottingham NG7 2UH
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I. K. Moppett and J. G. Hardman Development and Validation of an Integrated Computational Model of Cerebral Blood Flow and Oxygenation Anesth. Analg., October 1, 2007; 105(4): 1094 - 1103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. T. Wong, I. Luginbuehl, C. Karsli, and B. Bissonnette The effect of sevoflurane on cerebral autoregulation in young children as assessed by the transient hyperemic response. Anesth. Analg., April 1, 2006; 102(4): 1051 - 1055. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. K. Moppett and R. P. Mahajan Transcranial Doppler ultrasonography in anaesthesia and intensive care Br. J. Anaesth., November 1, 2004; 93(5): 710 - 724. [Full Text] [PDF]
|
|
|
|
|
|
R. Sherman, P. Armory, P. Moody, T. Hope, and R. P. Mahajan Effects of magnesium sulphate on cerebral haemodynamics in healthy volunteers: a transcranial Doppler study Br. J. Anaesth., August 1, 2003; 91(2): 273 - 275. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Webster and R. P. Mahajan Transient hyperaemic response to assess vascular reactivity of skin; effect of locally iontophoresed sodium nitroprusside{dagger} Br. J. Anaesth., August 1, 2002; 89(2): 265 - 270. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. M. Bedforth, K. J. Girling, H. J. Skinner, and R. P. Mahajan Effects of desflurane on cerebral autoregulation Br. J. Anaesth., August 1, 2001; 87(2): 193 - 197. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. K. Tibble, K. J. Girling, and R. P. Mahajan A Comparison of the Transient Hyperemic Response Test and the Static Autoregulation Test to Assess Graded Impairment in Cerebral Autoregulation During Propofol, Desflurane, and Nitrous Oxide Anesthesia Anesth. Analg., July 1, 2001; 93(1): 171 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. M. Bedforth, K. J. Girling, J. M. Harrison, and R. P. Mahajan The Effects of Sevoflurane and Nitrous Oxide on Middle Cerebral Artery Blood Flow Velocity and Transient Hyperemic Response Anesth. Analg., July 1, 1999; 89(1): 170 - 170. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Girling, G. Cavill, and R. P. Mahajan The Effects of Nitrous Oxide and Oxygen on Transient Hyperemic Response in Human Volunteers Anesth. Analg., July 1, 1999; 89(1): 175 - 175. [Abstract] [Full Text] [PDF]
|
|