Cerebral autoregulation in patients with cirrhosis and ascites - A transcranial Doppler study

被引:31
|
作者
Lagi, A
LaVilla, G
Barletta, G
Cencetti, S
Bacalli, S
Cipriani, M
Foschi, M
Lazzeri, C
DelBene, R
Gentilini, P
Laffi, G
机构
[1] UNIV FLORENCE,SCH MED,IST MED INTERNA,I-50134 FLORENCE,ITALY
[2] UNIV FLORENCE,SCH MED,MODULO ECOG CARDIOVASC,I-50134 FLORENCE,ITALY
[3] OSPED SANTA MARIA NUOVA,DIPARTIMENTO MED INTERNA,FLORENCE,ITALY
关键词
cerebral circulation; hemodynamics; liver cirrhosis; transcranial Doppler;
D O I
10.1016/S0168-8278(97)80289-9
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Patients with cirrhosis and ascites usually show alterations of systemic hemodynamics and are thus prone to develop arterial hypotension, which might result in cerebral hypoperfusion of cerebral autoregulation is impaired. Methods: We evaluated cerebral autoregulation in 15 patients with cirrhosis and ascites and 15 healthy subjects by monitoring mean blood flow velocity in the middle cerebral artery and arterial pressure during supine rest and passive tilting. Results: Tilt provoked a drop of arterial pressure in both groups. Control subjects had a prompt recovery of mean flow velocity and a progressive recovery of arterial pressure, so that, after 120 s, both parameters had returned to baseline: at 20 s the recovery of flow velocity was faster (p<0.01) than that of blood pressure. By contrast, patients with cirrhosis had a delayed and incomplete recovery of both parameters (p<0.01 vs healthy subjects). In eight patients, the recovery of mean flow velocity paralleled that of arterial pressure, indicating an impaired cerebral autoregulation. These patients had a worse liver function, a higher cardiac index and lower peripheral resistance. Conclusions: Cerebral autoregulation is often impaired in patients with cirrhosis and ascites. These patients can develop cerebral hypoperfusion if arterial pressure falls abruptly.
引用
收藏
页码:114 / 120
页数:7
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