The pathophysiology of hypoxic ischemic brain injury after cardiac arrest
department or school: Health and Social Development, Faculty of (Okanagan)
department or school: Health and Exercise Sciences, School of (Okanagan)
data provider: DSpace
degree campus: UBCO
creator: Sekhon, Mypinder Myp
issued: 2021-02-22T19:21:09Z
issued: 2021
related degree: Doctor of Philosophy - PhD
degree grantor: University of British Columbia
description: The pathophysiology of hypoxic ischemic brain injury comprises of an initial primary injury during circulatory arrest followed by the secondary injury following return of spontaneous circulation. Management strategies are aimed at mitigating the negative consequences of secondary injury to improve long term neurological outcome. This thesis aimed to: 1) delineate the underlying cerebrovascular pathophysiology of secondary injury following return of spontaneous circulation; and, 2) establish important physiologic relationships between the physiologic determinants of cerebral oxygen delivery and brain tissue oxygenation in hypoxic ischemic brain injury. Study 1 investigated the burden of brain hypoxia following return of spontaneous circulation and determined the relationships between physiologic determinants of cerebral oxygen delivery with brain tissue oxygenation. Episodes of brain hypoxia were prevalent following resuscitation. Study 2 sought to delineate the state of autoregulation in hypoxic ischemic brain injury patients and identify the optimal within- individual mean arterial pressure. Overall, autoregulation was dysfunctional during â¼50% of the monitoring but with significant heterogeneity. Study 3 investigated the temporal patterns of intracranial pressure and compliance in hypoxic ischemic brain injury patients after return of spontaneous circulation. Overall, hypoxic ischemic brain injury was characterized by low intracranial pressure but abnormal intracranial compliance. Study 4 examined the mechanisms of brain hypoxia after cardiac arrest and determined the presence of diffusion limitation of oxygen delivery physiology in hypoxic ischemic brain injury patients. The results identified distinct physiologic phenotypes in that diffusion limitation of oxygen delivery accounted for the predominant mechanism of brain hypoxia after resuscitation in half of the cohort; the remaining patients in the study exhibited physiologic patterns consistent with dependence…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/77350
note: The Pathophysiology of Hypoxic Ischemic Brain Injury After Cardiac Arrest by Mypinder Myp Sekhon Doctor of Medicine, The University of British Columbia, 2008 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE COLLEGE OF GRADUATE STUDIES (Kinesiology) THE UNIVERSITY OF BRITISH COLUMBIA (Okanagan) February 2021 © Mypinder Myp Sekhon, 2021 i The following individuals certify that they have read, and recommend to the College of Graduate Studies for acceptance, a thesis/dissertation entitled: THE PATHOPHYSIOLOGY OF HYPOXIC ISCHEMIC BRAIN INJURY AFTER CARDIAC ARREST submitted by Mypinder Myp Sekhon in partial fulfillment of the requirements of the degree of Doctor of Philosophy Philip N. Ainslie, School of Exercise and Health Sciences, UBC-Okanagan Supervisor Neil. Eves, School of Health and Exercise Sciences, UBC-Okanagan Supervisory Committee Member Donald E. Griesdale, Department of Anesthesiology, Therapeutics and Pharmacology, Faculty of Medicine, UBC Supervisory Committee Member Alexander Rauscher, Department of Pediatrics, Faculty of Medicine, UBC University Examiner Andrew Baker, Department of Anesthesiology and Interdepartmental Critical Care Medicine, Faculty of Medicine, University of Toronto External Examiner ii ABSTRACT The pathophysiology of hypoxic ischemic brain injury comprises of an initial primary injury during circulatory arrest followed by the secondary injury following return of spontaneous circulation. Management strategies are aimed at mitigating the negative consequences of secondary injury to improve long term neurological outcome. This thesis aimed to: 1) delineate the underlying cerebrovascular pathophysiology of secondary injury following return of spontaneous circulation; and, 2) establish important physiologic relationships between the physiologic determinants of cerebral oxygen delivery and brain tissue oxygenation in hypoxic ischemic brain injury. Study 1 investigated the burden of …
has type: Thesis/Dissertation
date issued: 2021-05
is shown at: 10.14288/1.0395938
language: eng
degree discipline: Kinesiology
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/77350