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Trigeminal Cardiac Reflex: New Thinking Model About the Definition Based on a Literature Review

机译:三叉神经反射:基于文献综述的关于定义的新思维模型

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摘要

Trigeminocardiac reflex (TCR) is a brainstem reflex that manifests as sudden onset of hemodynamic perturbation in blood pressure (MABP) and heart rate (HR), as apnea and as gastric hypermotility during stimulation of any branches of the trigeminal nerve. The molecular and clinical knowledge about the TCR is in a constant growth since 1999, what implies a current need of a review about its definition in this changing context.Relevant literature was identified through searching in PubMed (MEDLINE) and Google scholar database for the terms TCR, oculocardiac reflex, diving reflex, vasovagale response.The definition of the TCR varies in clinical as well as in research studies. The main difference applies the required change of MABP and sometimes also HR, which most varies between 10% and 20%. Due to this definition problem, we defined, related to actual literature, 2 major (plausibility, reversibility) and 2 minor criteria (repetition, prevention) for a more proper identification of the TCR in a clinical or research setting. Latest research implies that there is a need for a more extended classification with 2 additional subgroups, considering also the diving reflex and the brainstem reflex.In this review, we highlighted criteria for proper definition and classification of the TCR in the light of increased knowledge and present a thinking model to overcome this complexity. Further we separately discussed the role of HR and MABP and their variation in this context. As another subtopic we gave attention to is the chronic TCR; a variant that is rarely seen in clinical medicine.
机译:三叉神经反射(TCR)是脑干反射,表现为血压(MABP)和心率(HR)的血流动力学扰动突然发作,在三叉神经的任何分支受刺激时呼吸暂停和胃动力亢进。自1999年以来,有关TCR的分子和临床知识一直在不断增长,这意味着当前需要在这种变化的背景下对其定义进行综述。通过在PubMed(MEDLINE)和Google学者数据库中搜索相关术语,可以找到相关文献TCR,眼心反射,潜水反射,血管迷走神经反应.TCR的定义在临床和研究中均有所不同。主要区别在于所需的MABP更改,有时还适用HR,大多数更改在10%到20%之间。由于存在这个定义问题,我们根据实际文献定义了2个主要(合理性,可逆性)和2个次要标准(重复,预防),以便在临床或研究环境中更正确地识别TCR。最新研究表明,需要进一步扩展分类以增加2个亚组,同时还要考虑潜水反射和脑干反射。在这篇综述中,我们根据知识和知识的增长突出了正确定义和分类TCR的标准。提出一种思维模型来克服这种复杂性。此外,在此背景下,我们分别讨论了HR和MABP的作用及其变化。作为我们关注的另一个子主题,是慢性TCR。一种在临床医学中很少见的变体。

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