TYK256

The long-held assumption that the lower limit of autoregulation decreases with younger age is no longer considered true. Instead, the lower limit of cerebral autoregulation has recently been shown to be similar among all ages. The clinical implication of this means:

a) infants may tolerate mild hypotension better than adolescents and adults, without significantly affecting cerebral perfusion

b) neonates and infants are susceptible to cerebral ischemia

c) infants can tolerate higher ICP compared to adolescents or adults

d) infants can have a lower CPP than adults without any occurrence of cerebral ischemia

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Answer

Answer b. Young infants typically have a lower baseline blood pressure than adults. With a lower limit of autoregulation of 60 mmHg, infants are especially prone to cerebral ischemia with even mild hypotension due to lower blood pressure reserve. As a result, these infants may require vasopressor support to achieve a higher blood pressure to maintain adequate cerebral perfusion and minimize brain ischemia.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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