Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
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Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
Yale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit toregulation-Based Blood Pressure Management In The Neuroscience Intensive Care Unit: Towards Individualizing Care In Ischemic stroke And Subarachnoid HemorrhageAndrew SilvermanFollow this and additional works at: https://elischolar.library.yale.edu/ymtdlRecommended CitationSilverman. Andrew, "Cereb Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit ral Autoregulation-Based Blood Pressure Management In The Neuroscience Intensive Care Unit: Towards Individualizing Care In Ischemic Stroke And SubaraLuận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
chnoid Hemorrhage' (2020). Yale Medicine Thesis Digital Library. 3951.https://elischolar.library.yale.edu/ymtdl/3951This Open Access Thesis is broughtYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit or inclusion in Yale Medicine Thesis Digital Library by an authorized administrator of EliScholar - A Digital Platform for Scholarly Publishing at Yale. For more information, please contact elischolar@yale edu.Cerebral autoregulation-based blood pressure management in the neuroscience intensive care Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit unitTowards individualizing care It) ischemic stroke and subarachnoid hemorrhageA Thesis Submitted to theYale University School of Medicine in PartiaLuận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
l Fulfillment of the Requirements for the Degiee of Doctor of MedicinebyAndrew SilvermanClass of 2020ABSTRACTThe pinpose of this thesis is to review tYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit impaired autoregulation on functional and clinical outcomes following subarachnoid hemorrhage and ischemic stroke. Autoregulation plays a key role ill the regulation of brain blood How and has been shown Io fail in acute brain injury. Disturbed autoregulalion may lead to secondary brain injury as we Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit ll as worse outcomes. Furthermore, there exist several methodologies, both invasive ami non-invasivc. for the continuous assessment of aitloregulalionLuận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
in individual patients. Resultant anlorcgulalory parameters ofbrain blood How can be harnessed Io derive optimal cerebral perfusion pressures, which Yale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit n arterial pressure in this fashion.The thesis herein argues for the high degree of translatability of this personalized approach w ithin the neuroscience intensive care unit, while underscoring the clinical import of autoregulation monitoring in critical care patients. In particular, this document Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit recapitulates findings from two separate, prospectively enrolled patient groups with subarachnoid hemorrhage and ischemic stroke, elucidating how deviLuận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
ation from dynamic and personalized blood pressure targets associates with worse outcome in each cohort. While definitive clinical benefits remain eluYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit ic environment for the injured brain.The first portion of this thesis discusses basic autoregulatory physiology as well as var ious tools to interrogate the brain's pressure reactivity at the bedside. It then reviews the development of the optimal cerebral perfusion pressure as a biological hemodyna Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit mic construct. lhe second chapter pertains to the clinical applications of bedside neuromonitoring in patients with aneurysmal subarachnoid hemorrhageLuận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
. In this section, the personalized approach to blood pressure monitoring is discussed in greater detail. Finally, in the thud chapter, a similar autoYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit ividualized strategy to hemodynamic management in stroke patients represents a better alternative to the currently endorsed practice of maintaining systolic blood pressures below fixed and static thresholds.ACKNOWLEDGMENTSThis work would not have been possible Without the leadership and encouragemen Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit t of Di. Nils Petersen. I could not have asked for a more insightful, creative, and patient mentor. It has been an extraordinary opportunity learn aboLuận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
ut physiology, critical care, and balancing research and clinical work from such a dedicated and kind role model.Many thanks also to our larger researYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit medial students at Harvard and Yale, respectively, were incredible teammates tluoughout my research year. They helped emoll patients, problem solve, and run new sciipts. Then energy and friendship sustained me during some of the longer days (and nights) of neuromonitoring and abstract construction b Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit efore midnight deadlines.More gratitude to my thesis committee and mentors in the Neurology Department, including Dr. Emily Gihnore. Dr. Kevin Sheth.Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
Di. Charles Wira. and Dr. Charles Matouk. In particular. Dr. Gilmore volunteered her time to adjudicate clinical and radiologic scores for over 30 patYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit with a suitable woikspace for an entire year.Thank you to Yale’s amazing Office of Student Research: Donna Carranzo. Kelly Jo Carlson. Reagin Carney, and Dr. John Forrest. Without their coordination efforts and sponsorship. I would not have been able to obtain funding from the American Heart Associa Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit tion, practice presenting my work at research 111 progress meetings. 01 learn about my peels’ awesome project developments -not to mention all the cofLuận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
fee and snacks they provided.Much gratitude, as always, to my grandma, my mom. my older brother, and to Lauren. Although they are not in the medical fYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral Aut Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit he patients and families who volunteered to participate m OIU' studies. Research reported m this publication was supported by the American Heait Association (AHA) Founders Affiliate training award for medical students as well as the Richard A. Moggio Student Research Fellowship from Yale.TABLE OF CO Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit NTENTSPARTI.........................................................................1A.Introduction: a brief history of autoregulation research.......Luận văn Thạc sĩ Cerebral AutoregulationBased Blood Pressure Management In The Neuroscience Intensive Care Unit
........1B.Cerebral blood flow regulation and physiology..........................8Yale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral AutYale UniversityEliScholar - A Digital Platform for Scholarly Publishing at YaleYale Medicine Thesis Digital LibrarySchool of Medicine43831Cerebral AutGọi ngay
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