Improvement of new technology for assessment of adequate cerebral blood perfusion

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Cerebral autoregulation is a protective mechanism that maintains optimal brain blood flow and oxygen deliveryindependent of changes in blood pressure. However, this protective mechanism has limits; blood pressures thatare too high or too low may exceed the ability of the brain's autoregulation mechanism(s) leading to anexcessive level of under- or over- perfusion. For example, in surgical patients, blood pressure often exceeds theupper and/or lower limits of cerebral autoregulation, yet clinicians may not recognize that the patient's cerebralperfusion is compromised and thus do not intervene. This issue stems from an absence of evidence based,standardized and effective technology that can be used to evaluate cerebral autoregulation, especially inreal-time. Therefore, improved cerebral autoregulation monitoring technology capable of detecting andinforming clinicians about the patient's cerebral autoregulation and brain blood flow is necessary. The first stepto address this issue is the development of a standard for the improvement of cerebral autoregulationmonitoring technology: the company (Medtronic) and University (Prof Ainslie) will be required to define andsubstantiate cerebral autoregulation monitoring approaches as part of a technology development process.