Early neurovascular uncoupling in the brain during community acquired pneumonia
Critical Care, 04/25/2012
Rosengarten B et al. – The study underlines the role of an early microcirculatory dysfunction in inflammatory syndromes getting evident in pre–septic conditions with a gradually decline according to disease severity.
Patients were investigated in the acute phase of pneumonia and after recovery.
The neurovascular coupling was investigated with a simultaneous electroencephalogram (EEG)-Doppler technique applying a visual stimulation paradigm.
Resting EEG frequencies, visual evoked potentials as well as resting and stimulated hemodynamic responses were obtained.
Disease severity was characterized by laboratory and cognitive parameters as well as related scoring systems.
Data were compared to a control group.
Whereas visually evoked potentials (VEP) remained stable a significant slowing and therefore uncoupling of the hemodynamic responses was found in the acute phase of pneumonia (Rate time: control group: 3.6+/-2.5 vs. acute pneumonia: 1.6+/-2.4 s; P<0.0005).
Patients, who deteriorated, showed in the initial investigation also a decreased hemodynamic response as compared to those who recovered (Gain: recovered: 15+/-4 vs. deteriorated: 9+/-3, P<0.05; control: 14+/-5 %).
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