Impaired cerebral autoregulation and 6-month outcome in children with severe traumatic brain injury: Preliminary findings

被引:57
作者
Vavilala, M. S.
Muangman, S.
Tontisirin, Nuj
Fisk, D.
Roscigno, C.
Mitchell, P.
Kirkness, C.
Zimmerman, J. J.
Chesnut, Randall
Lam, A. M.
机构
[1] Univ Washington, Harborview Med Ctr, Dept Anesthesiol, Seattle, WA 98104 USA
[2] Univ Washington, Dept Pediat, Seattle, WA 98104 USA
[3] Univ Washington, Dept Neurol Surg, Seattle, WA 98104 USA
[4] Univ Washington, Dept Biobehav Nursing, Seattle, WA 98104 USA
关键词
cerebral blood flow; cerebral autoregulation; pediatric head injury;
D O I
10.1159/000094161
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
The objective of this study was to describe the incidence of impaired cerebral autoregulation and to describe the relationship between impaired cerebral autoregulation and outcome after severe pediatric traumatic brain injury (TBI). We prospectively examined cerebral autoregulation in 28 children <= 17 (10 +/- 5) years with a Glasgow coma scale score < 9 within the first 72 h of pediatric intensive care unit admission. Children with isolated focal TBI were excluded. Glasgow outcome scores (GOS) were collected at hospital discharge, as well as 3 and 6 months after severe TBI. GOS < 4 reflected poor outcome. Cerebral autoregulation was impaired in 12/28 children. An autoregulatory index < 0.4 was associated with GOS < 4 at 6 months (p = 0.005). Impaired cerebral autoregulation, early after severe pediatric TBI, was associated with a poor 6-month outcome. Copyright (c) 2006 S. Karger AG, Basel.
引用
收藏
页码:348 / 353
页数:6
相关论文
共 19 条
[1]   Effects of desflurane on cerebral autoregulation [J].
Bedforth, NM ;
Girling, KJ ;
Skinner, HJ ;
Mahajan, RP .
BRITISH JOURNAL OF ANAESTHESIA, 2001, 87 (02) :193-197
[2]   Influence of definition and location of hypotension on outcome following severe pediatric traumatic brain injury [J].
Coates, BM ;
Vavilala, MS ;
Mack, CD ;
Muangman, S ;
Suz, P ;
Sharar, SR ;
Bulger, E ;
Lam, AM .
CRITICAL CARE MEDICINE, 2005, 33 (11) :2645-2650
[3]   Age, intracranial pressure, autoregulation, and outcome after brain trauma [J].
Czosnyka, M ;
Balestreri, M ;
Steiner, L ;
Smielewski, P ;
Hutchinson, PJ ;
Matta, B ;
Pickard, JD .
JOURNAL OF NEUROSURGERY, 2005, 102 (03) :450-454
[4]   Monitoring of cerebral autoregulation in head-injured patients [J].
Czosnyka, M ;
Smielewski, P ;
Kirkpatrick, P ;
Menon, DK ;
Pickard, JD .
STROKE, 1996, 27 (10) :1829-1834
[5]   PROGNOSIS OF PATIENTS WITH SEVERE HEAD-INJURY [J].
JENNETT, B ;
TEASDALE, G ;
BRAAKMAN, R ;
MINDERHOUD, J ;
HEIDEN, J ;
KURZE, T .
NEUROSURGERY, 1979, 4 (04) :283-289
[6]   Cerebral autoregulation following minor head injury [J].
Junger, EC ;
Newell, DW ;
Grant, GA ;
Avellino, AM ;
Ghatan, S ;
Douville, CM ;
Lam, AM ;
Aaslid, R ;
Winn, HR .
JOURNAL OF NEUROSURGERY, 1997, 86 (03) :425-432
[7]   The effects of hypercapnia on cerebral autoregulation in ventilated very low birth weight infants [J].
Kaiser, JR ;
Gauss, CH ;
Williams, DK .
PEDIATRIC RESEARCH, 2005, 58 (05) :931-935
[8]   INTRAOPERATIVE TRANSCRANIAL DOPPLER MONITORING [J].
LAM, AM .
ANESTHESIOLOGY, 1995, 82 (06) :1536-1537
[9]   Monitoring of autoregulation using laser Doppler flowmetry in patients with head injury [J].
Lam, JMK ;
Hsiang, JNK ;
Poon, WS .
JOURNAL OF NEUROSURGERY, 1997, 86 (03) :438-445
[10]   Direct cerebral vasodilatory effects of sevoflurane and isoflurane [J].
Matta, BF ;
Heath, KJ ;
Tipping, K ;
Summors, AC .
ANESTHESIOLOGY, 1999, 91 (03) :677-680