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فشار پرفیوژن کلترال
According to the myogenic hypothesis, changes in CPP lead to direct changes in the tone of vascu- lar smooth muscle; this process appears to be passive.
The conventional view of cerebral hemodynamics is that perfusion pressure (MAP or CPP) is the primary determi- nant of CBF and that the influence of cardiac output is lim- ited.
In patients with a head injury, the admin- istration of phenylephrine increased CPP and did not reduce regional CBF.36 Transient changes may occur in CBF and rSO2 (on the order of 2-5 minutes) in response to bolus doses of phenylephrine; however, with a continuous infusion, a1- agonists have little direct influence on CBF and cerebral oxy- genation in humans.34 Thus maintenance of CPP with these vasopressors does not have an adverse effect on the brain.
However, the well-known effect of dexmedetomidine in decreas- ing arterial blood pressure merits careful consideration if used in patients who are critically dependent on collateral perfusion pressure, especially in the recovery phase of an anesthetic.
intracranial compliance* is reduced, an increase in CBV can cause herniation or sufficiently reduce CPP to cause ischemia.
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