• Ann Fr Anesth Reanim · Jul 2006

    Review

    [Cerebral ischemic threshold in clinical practice].

    • A Daboussi and O Fourcade.
    • Département d'anesthésie-réanimation, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, 31059 Toulouse cedex 09, France.
    • Ann Fr Anesth Reanim. 2006 Jul 1;25(7):729-34.

    AbstractThe ischemic threshold is reached when the availability of oxygen in the cerebral tissue does not cover oxygen requirement. For a patient sedated, with constant PaO(2) and haemoglobin, the cerebral blood flow (CBF) global and local is the essential factor to maintain such a balance. At a cellular level, ischemia occurs when the CBF is below 20-25 ml/min. However, this threshold probably varies with the patient and also within the normal or perilesional tissue. A cerebral perfusion pressure (CPP) of 60 mmHg, recommended for a cerebral perfusion allowing a sufficient CBF for normal brain, does not prevent ischemia. Monitoring aimed to control parameters of the aerobic metabolism (PtiO(2), SjO(2) and microdialysis) and to detect the ischemic threshold allows to adapt the CPP to each patient and continuously.

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