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27 authors, 
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P07

Two patients with cyclic blood pressure variation after cardiac arrest

Friday, 25 May, 2012 - 11:10
Board 3

Cyclic blood pressure (BP) and cardiac output variation in varying frequencies and depth have been observed in critically ill patients (1-4). A 67-year-old male was admitted after CPR. He showed a cyclic variation of systolic BP between 80 and 150 mm Hg with a cycle of 1/minute. There was only a slight variation in heart rate during this period. The cyclic variation disappeared after clonidine was administered. The patient recovered and could be discharged from the hospital in good neurological condition. The second patient, also after CPR, showed cyclic BP variation with a cycle of one per 10 minutes. She died without regaining consciousness. First-order waves have a length of about 1s and are periodic variations in BP corresponding to each heartbeat. Second-order waves have a duration of about 5s and are corresponding to respiratory variation. Third-order waves typically last 10-160s and can be caused by various pathological states, such as brainstem ischemia. Fourth-order waves can vary in length from minutes up to hours. These waves are believed to be caused by impaired tissue oxygen delivery. These cycles have also been seen in patients with raised intracranial pressure and during sleep cycles (5). The slower waves are sometimes called Traube-Hering-Mayer waves, but can best be termed "repetitive synchronized cyclical oscillations". The clinical relevance is unknown.
Part of Session

Neurological Critical Care

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