Improvement of new technology for assessment of adequate cerebral blood perfusion

脑自动调节是一种保护机制，可维持最佳脑血流量和氧气输送，不受血压变化的影响。然而，这种保护机制有其局限性;过高或过低的血压可能超过大脑自动调节机制的能力，导致过度灌注或灌注不足。例如，在手术患者中，血压经常超过脑自动调节的上限和/或下限，但临床医生可能没有意识到患者的脑灌注受损，因此不进行干预。这个问题源于缺乏基于证据的，标准化的和有效的技术，可用于评估大脑自动调节，特别是实时的。因此，改进的脑自动调节监测技术能够检测和告知临床医生有关患者的脑自动调节和脑血流是必要的。解决这个问题的第一步是制定一个标准，以改善大脑自动调节监测技术：公司（美敦力）和大学（Ainslie教授）将被要求定义和证实大脑自动调节监测方法，作为技术开发过程的一部分。

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.