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.

Methods

  • 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.

Results

  • 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 %).
  • After recovery the coupling normalized.

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