Hemodynamic physiology during perioperative intracranial hypertension. Monitoring and therapeutic implications

PhD ceremony: Mr. A.F. Kalmar, 13.15 uur, Academiegebouw, Broerstraat 5, Groningen

Title: Hemodynamic physiology during perioperative intracranial hypertension. Monitoring and therapeutic implications

Promotor(s): prof. M.M.R.F. Struys, prof. E.P. Mortier, prof. A.R Absalom

Faculty: Medical Sciences

 

New surgical treatment options, such as endoscopic neurosurgery, require adequate monitoring and management of the intracranial pressure, cerebral oxygenation and homeostasis. In this thesis a new methodology is described that significantly improves perioperative monitoring.

Endoscopic neurosurgical procedures may result in increased intracranial pressure and acute hemodynamic effects. It was shown that the initial phase of this so called Cushing reflex consists of a combination of hypertension and tachycardia. These clinical findings were confirmed in a rat-model of endoscopic neurosurgery, which resulted in the investigation of various methods to monitor the Cushing reflex. The newly developed method is significantly more precise as compared to the present approach.