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There's an ongoing study looking at the effect of beach chair vs lateral position on cerebral autoregulation and cardiac output. It'll help answer many of our questions
http://clinicaltrials.gov/ct2/show/NCT01225185?term=hogue&rank=6
Johns Hopkins Med Ctr and they ae using a biomarker. Still, the results will be interesting but not definitive.
The co-sponsor is the APSF the same group which recommends a higher mean BP in the beach chair position and the same group which has brought all this to our attention.
The study should be completed by now (they used a biomark and cerebral oximetry) so I expect the published results in 2013.
The specific aims of this study are:
- To compare the average cerebral oximetry index and the percentage of time with abnormal COx between subjects in the head up or supine position during surgery under general anesthesia.
- To compare the range of arterial blood pressure required for a normal cerebral oximetry index between subjects anesthetized in the head up or supine position.
- To assess the association between impaired cerebral blood flow autoregulation and postoperative neurocognitive decline 1 month after surgery and perioperative elevation of serum glial fibrillary acid protein.