The gravitational gradient at the bed-rest mode in patients with acute cerebral insufficiency
Belkin A. A., Alsheev A. M., Leiderman I. N., Pochepko D. V.,
Hulin A. V., Davydova N. S.
Clinical Institute of Brain; Ural State Medical University; Regional Hospital No. 1, Ekaterinburg, Russian Federation
Abstract.
Immobilization syndrome is a complex multi-organ disorders associated with non-physiological limitation of motor and cognitive activity during bed-rest mode. The only way to overcome immobilization syndrome in terms of preservation of the gravitational gradient is the plumbing of the patient. The main obstacle for this is — orthostatic failure (core). Within a prospective cohort single center non-randomized study tested the hypothesis that the state of autoregulation of the cerebral circulation in a patient with acute cerebral insufficiency (ACI) reflects the degree of violation of the gravitational gradient and may be a predictor of the development of the core. Included 143 patients (ages 6 to 70 years). Of these 93 patients who were in a horizontal position for 24 hours or more, in the post operative period after aneurysmal subarachnoid hemorrhage. As a control results used orthostatic test in 50 patients with functional disorders of the nervous system. All patients were measured using transcranial Doppler test was conducted transient hyperemia at different angles of ascent to the head end in the range 0–90°. Lifting was carried out only up to the level, while the coefficient overshoot (KO) retained the normal value. Results: all patients with ACI, who have reached the top level of verticalization decreased (KO) in contrast to its persistence in the control group. When using the integral indicator KV was that the state of autoregulation of the cerebral circulation determines the outcome of acute cerebral insufficiency and may be an indicator of the effectiveness of early rehabilitation.
Key words:
PIT syndrome; bed-rest; orthostatic failure, acute cerebral insufficiency, the coefficient plumbing, immobilization syndrome, the gravitational gradient of autoregulation of the cerebral circulation
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Authors
Belkin Andrey A.
MD, PhD, Professor of the Anesthesia and Reanimatology and Neurology Departments of the Ural State Medical University
Russian Federation, 623702, Sverdlovsk oblast, st. Shilovsky, 28, Bldg. 6, Berezovsky,
Alasheev Andrey M.
MD, PhD, assistant professor of the Anesthesia and reanimatology Department of the Ural State Medical University
Russian Federation, Ekaterinburg 620028, Repina,3
Davydova Nadegda S.
MD, PhD, Full Professor, Chief of the Anesthesia and Reanimatology Department of the Ural State Medical University
Russian Federation, Ekaterinburg 620028, Repina,3
Chalin Alexey V.
Critical Care Physician, Critical Care Department of the Clinics of The Institute of Brain
Russian Federation, 623702, Sverdlovsk oblast, st. Shilovsky, 28, Bldg. 6, Berezovsky,
Pochepko Dmitry V.
Critical Care Physician, Critical Care
Department of the Clinics of The Institute of Brain
Russian Federation, 623702, Sverdlovsk oblast, st. Shilovsky, 28, Bldg. 6, Berezovsky,
Leiderman Ilya N.
MD, PhD, Full Professor, Chief of the Critical Care Department of the Clinics of The Institute of Brain
Russian Federation, 623702, Sverdlovsk oblast, st. Shilovsky, 28, Bldg. 6, Berezovsky,