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Canadian Journal of Anesthesia 52:323-326 (2005)
© Canadian Anesthesiologists' Society, 2005
Neuroanesthesia and Intensive Care

Hyperemia and impaired cerebral autoregulation in a surgical patient with diabetic ketoacidosis

[L’hyperémie et l’autorégulation cérébrale altérée chez un patient de chirurgie atteint d’acidocétose diabétique]

Monica S. Vavilala, MD*, Michael J. Souter, MB CHB FRCA{dagger} and Arthur M. Lam, MD FRCPC{ddagger}

* From the Departments of Anesthesiology,
{dagger} Pediatrics, and
{ddagger} Neurological Surgery, University of Washington, Seattle, Washington, USA.

Address correspondence to: Dr. Monica S. Vavilala, Department of Anesthesiology, Harborview Medical Center, 325 Ninth Avenue, Box 359724, Seattle, Washington 98104, USA. Phone: 206-731-3059; Fax: 206-731-8009; E-mail: vavilala{at}u.washington.edu

Objectif : Décrire l’hyperémie cérébrale et l’autorégulation cérébrale altérée documentées par le Doppler transcrânien (DTC) chez un adulte atteint d’acidocétose diabétique (ACD) et de septicémie admis pour une intervention chirurgicale.

Éléments cliniques : La vitesse du flux de l’artère cérébrale moyenne a augmenté en relation avec la PaCO2 (Vacm à 52 cm·sec –1;PaCO2 de 22 mmHg) et l’index d’autorégulation (IAR) était de 0 avant l’intervention chirurgicale. Vingt heures après l’admission et le traitement, l’hyperémie cérébrale était stoppée (Vmca à 52 cm·sec–1; PaCO2 de 35 mmHg) et l’autorégulation cérébrale revenue à la normale (IAR de 0,91).

Conclusion : Selon nous, c’est la première description d’autorégulation cérébrale altérée chez un adulte atteint d’ACD. Nos observations suggèrent une relation entre l’hyperémie cérébrale et l’autorégulation cérébrale altérée en cas d’ACD.





This Article
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