IngentaConnect Change in cerebral autoregulation as a function of time in childr...

Authors: Tontisirin, Nuj; Armstead, William; Waitayawinyu, Pichaya; Moore, Anne; Udomphorn, Yuthana; Zimmerman, Jerry; Chesnut, Randall; Vavilala, Monica¹

Source: Child's Nervous System, Volume 23, Number 10, October 2007 , pp. 1163-1169(7)

Publisher: Springer

Abstract:

The objective of this study was to describe changes in cerebral autoregulation after severe pediatric traumatic brain injury (TBI).

Two cerebral autoregulation tests were performed during the first 10 days after severe TBI in children <16 years. Cerebral autoregulation was quantified using the mean autoregulatory index (mARI).

Nine (five males/four females) children (10 ± 5 years) with severe (admission Glasgow Coma Scale (GCS), 5 ± 2) TBI were enrolled. Thirty (3/9) percent of initial exams revealed impaired cerebral autoregulation; all three had returned to intact cerebral autoregulation on second exam. However, in three of nine (33%) patients, cerebral autoregulation worsened on second exam. Of the factors examined, worsening mARI on second exam was associated with worsening head computed tomography (CT) lesion.

Cerebral autoregulation often changed and worsened during the first 9 days after severe pediatric TBI. Worsening cerebral autoregulation may mirror worsening TBI.

Keywords: Pediatric traumatic brain injury; Cerebral autoregulation; Cerebral blood flow; Pediatric trauma

Document Type: Research article

DOI: 10.1007/s00381-007-0339-0

Affiliations: 1: Email: vavilala@u.washington.edu

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Change in cerebral autoregulation as a function of time in children after severe traumatic brain injury: a case series