title: Comparison of static and dynamic cerebral autoregulation measurements.
abstract: OBJECTIVE
  Cerebral autoregulation can be evaluated by measuring relative blood flow changes in response to a steady-state change in the blood pressure (static method) or during the response to a rapid change in blood pressure (dynamic method). The purpose of this study was to compare the results of the two methods in humans with both intact and impaired autoregulatory capacity.
  
  
  METHODS
  Using intraoperative transcranial Doppler sonography recordings from both middle cerebral arteries, we determined static and dynamic autoregulatory responses in 10 normal subjects undergoing elective surgical procedures. The changes in cerebrovascular resistance were estimated from the changes in cerebral blood flow velocity and arterial blood pressure in response to manipulations of blood pressure. Static autoregulation was determined by analyzing the response to a phenylephrine-induced rise in blood pressure, whereas rapid deflation of a blood pressure cuff around one thigh served as a stimulus for testing dynamic autoregulation. Both measurements were performed in patients with intact autoregulation during propofol anesthesia and again in the same patients after autoregulation had been impaired by administration of high-dose isoflurane.
  
  
  RESULTS
  There was a significant reduction in autoregulatory capacity after the administration of high-dose isoflurane, which could be demonstrated using static (P < .0001) and dynamic (P < .0001) methods. The correlation between static or steady-state and dynamic autoregulation measurements was highly significant (r = .93, P < .0001).
  
  
  CONCLUSIONS
  These data show that in normal human subjects measurement of dynamic autoregulation yields similar results as static testing of intact and pharmacologically impaired autoregulation.
authors.affiliation: Department of Neurological Surgery, University of Washington, Harborview Medical Center, Seattle, USA.
authors.forename: F P
authors.initials: FP
authors.lastname: Tiecks
authors.forename: A M
authors.initials: AM
authors.lastname: Lam
authors.forename: R
authors.initials: R
authors.lastname: Aaslid
authors.forename: D W
authors.initials: DW
authors.lastname: Newell
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D001794:Blood Pressure; D001921:Brain / Q000098:blood supply*; D002245:Carbon Dioxide / Q000097:blood; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007530:Isoflurane / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D015742:Propofol / Q000494:pharmacology; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D002245:Carbon Dioxide; D007530:Isoflurane; D015742:Propofol