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Effect of Head Rotation on Cerebral Blood Velocity in the Prone Position
Joint Authors
Sandmand, Marie
Sonne, Morten
Mantoni, Teit
Belhage, Bo
Højlund, Jakob
van Lieshout, Johannes J.
Jørgensen, Henrik L.
Pott, Frank C.
Source
Anesthesiology Research and Practice
Issue
Vol. 2012, Issue 2012 (31 Dec. 2012), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2012-09-05
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
The prone position is applied to facilitate surgery of the back and to improve oxygenation in the respirator-treated patient.
In particular, with positive pressure ventilation the prone position reduces venous return to the heart and in turn cardiac output (CO) with consequences for cerebral blood flow.
We tested in healthy subjects the hypothesis that rotating the head in the prone position reduces cerebral blood flow.
Methods.
Mean arterial blood pressure (MAP), stroke volume (SV), and CO were determined, together with the middle cerebral artery mean blood velocity (MCA Vmean) and jugular vein diameters bilaterally in 22 healthy subjects in the prone position with the head centered, respectively, rotated sideways, with and without positive pressure breathing (10 cmH2O).
Results.
The prone position reduced SV (by 5.4±1.5%; P<0.05) and CO (by 2.3±1.9 %), and slightly increased MAP (from 78±3 to 80±2 mmHg) as well as bilateral jugular vein diameters, leaving MCA Vmean unchanged.
Positive pressure breathing in the prone position increased MAP (by 3.6±0.8 mmHg) but further reduced SV and CO (by 9.3±1.3 % and 7.2±2.4 % below baseline) while MCA Vmean was maintained.
The head-rotated prone position with positive pressure breathing augmented MAP further (87±2 mmHg) but not CO, narrowed both jugular vein diameters, and reduced MCA Vmean (by 8.6±3.2 %).
Conclusion.
During positive pressure breathing the prone position with sideways rotated head reduces MCA Vmean ~10% in spite of an elevated MAP.
Prone positioning with rotated head affects both CBF and cerebrovenous drainage indicating that optimal brain perfusion requires head centering.
American Psychological Association (APA)
Højlund, Jakob& Sandmand, Marie& Sonne, Morten& Mantoni, Teit& Jørgensen, Henrik L.& Belhage, Bo…[et al.]. 2012. Effect of Head Rotation on Cerebral Blood Velocity in the Prone Position. Anesthesiology Research and Practice،Vol. 2012, no. 2012, pp.1-6.
https://search.emarefa.net/detail/BIM-487924
Modern Language Association (MLA)
Højlund, Jakob…[et al.]. Effect of Head Rotation on Cerebral Blood Velocity in the Prone Position. Anesthesiology Research and Practice No. 2012 (2012), pp.1-6.
https://search.emarefa.net/detail/BIM-487924
American Medical Association (AMA)
Højlund, Jakob& Sandmand, Marie& Sonne, Morten& Mantoni, Teit& Jørgensen, Henrik L.& Belhage, Bo…[et al.]. Effect of Head Rotation on Cerebral Blood Velocity in the Prone Position. Anesthesiology Research and Practice. 2012. Vol. 2012, no. 2012, pp.1-6.
https://search.emarefa.net/detail/BIM-487924
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-487924