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Perfusion Enhancement with Respiratory Impedance After Stroke (PERI-Stroke).


ABSTRACT: Intrathoracic pressure influences cardiac output and may affect cerebral blood flow (CBF). We aimed to quantify the cerebral hemodynamic response to intrathoracic pressure reduction in patients with acute ischemic stroke using a noninvasive respiratory impedance (RI) device. We assessed low-level (6 cm H2O) and high-level (12 cm H2O) RI in 17 spontaneously breathing patients within 72 h of anterior circulation acute ischemic stroke. Average age was 65 years, and 35% were female. Frontal lobe tissue perfusion and middle cerebral artery velocity (MCAv) were continuously monitored with optical diffuse correlation spectroscopy (DCS) and transcranial Doppler ultrasound, respectively. High-level RI resulted in a 7% increase in MCAv (p?=?0.004). MCAv varied across all studied levels (baseline vs low-level vs high-level, p?=?0.006), with a significant test of trend (p?=?0.002). Changes were not seen in DCS measured tissue perfusion by nonparametric pairwise comparison. Mixed effects regression analysis identified a small increase in both MCAv (low-level RI: ? 2.1, p?

SUBMITTER: Favilla CG 

PROVIDER: S-EPMC6985403 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Perfusion Enhancement with Respiratory Impedance After Stroke (PERI-Stroke).

Favilla Christopher G CG   Forti Rodrigo M RM   Zamzam Ahmad A   Detre John A JA   Mullen Michael T MT   Yodh Arjun G AG   Kasner Scott E SE   Busch David R DR   Baker Wesley B WB   Mesquita Rickson C RC   Kung David D   Messé Steven R SR  

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics 20191001 4


Intrathoracic pressure influences cardiac output and may affect cerebral blood flow (CBF). We aimed to quantify the cerebral hemodynamic response to intrathoracic pressure reduction in patients with acute ischemic stroke using a noninvasive respiratory impedance (RI) device. We assessed low-level (6 cm H<sub>2</sub>O) and high-level (12 cm H<sub>2</sub>O) RI in 17 spontaneously breathing patients within 72 h of anterior circulation acute ischemic stroke. Average age was 65 years, and 35% were fe  ...[more]

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