Cerebrovascular Autoregulation Impairment

A significant number of patients have impaired cerebral autoregulation during the acute phase after resuscitation from CA (74). The abnormality most noted was the absence of, or a right shift in, the cerebral blood flow autoregulatory curve (both of which require higher pressures for adequate perfusion) during the first 24 hours (74). In another study of human CA, survivors with good functional neurologic recovery were independently and positively associated with higher arterial blood pressure during the first two hours after arrest (75). With dysfunction of the auto-regulatory mechanism, improvement of cerebral perfusion might require a higher systemic blood pressure. Although the idea to increase blood pressure to promote cerebral perfusion could theoretically benefit some patients, caution is advised in patients with poor cardiovascular reserve.

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