cerebral autoregulation

CPP = MAP - ICP

Aim: maintain constant cerebral blood flow match to metabolic demand across a range of blood pressures (50-170 as quoted values from passmed)

normal values

ICP waveform - 3 peaks/trifid:

  • arterial pulsation
  • intracranial compliance
  • aortic valve closure
Affected by: Net effect Mechanism
PaCO2 ↑ PaCO2 = vasodilation → ↓ cerebral vascular resistance ↓ periarteriolar pH → change in NOS activity → ↑ intracellular cGMP production → ↑ intracellular Ca availability
PaO2 ↓ PaO2 → ↑ cerebral flow ???
K+ ↑ K+ → ↑ cerebral flow ???

Cerebral blood flow ↑ when metab demand is high