HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Continuous brain tissue oxygenation monitoring in the management of pediatric stroke.

AbstractBACKGROUND:
Direct invasive monitoring of brain tissue oxygenation (PbtO(2)) has been routinely utilized to predict cerebral ischemia and to prevent secondary injury in patients with traumatic brain injury (TBI) and vasospasm secondary to subarachnoid hemorrhage (SAH). The safety and utility of these devices in the pediatric population have been examined in a few small studies. No studies, however, have examined the use of PbtO(2) monitoring in stroke patients.
METHODS:
Retrospective chart review of the first two consecutive, critically ill pediatric patients in the pediatric intensive care unit requiring brain tissue oxygen monitoring for newly diagnosed cerebral ischemia. ICP, CPP, PbtO(2), SaO(2), BP, and RR were all continually monitored during their care and were retrospectively collected and reviewed.
RESULTS:
We present two pediatric stroke patients managed in a critical care setting with PbtO(2) monitoring in addition to ICP, MAP, CPP, and SaO(2). Both patients had multiple events of low brain tissue oxygen (PbtO(2) <20 torr), independent of abnormal values in other monitoring parameters, which required physician intervention. No new ischemic damage occurred after PbtO(2) monitoring began in either patient.
CONCLUSIONS:
There is currently inadequate data to support the application of PbtO(2) monitoring in children with stroke to prevent progressive ischemia and to improve outcome. However, the positive results for these two patients support the need for further study in this area.
AuthorsBaxter B Allen, Caitlin E Hoffman, Chani S Traube, Steven L Weinstein, Jeffrey P Greenfield
JournalNeurocritical care (Neurocrit Care) Vol. 15 Issue 3 Pg. 529-36 (Dec 2011) ISSN: 1556-0961 [Electronic] United States
PMID21416310 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Oxygen
Topics
  • Accidents, Traffic
  • Blood Pressure (physiology)
  • Brain (blood supply)
  • Brain Ischemia (blood, diagnosis)
  • Brain Neoplasms (blood, diagnosis)
  • Carotid Artery, Internal, Dissection (blood, diagnosis)
  • Child, Preschool
  • Critical Illness
  • Female
  • Glasgow Coma Scale
  • Heart Rate (physiology)
  • Humans
  • Image Interpretation, Computer-Assisted
  • Infarction, Middle Cerebral Artery (blood, diagnosis)
  • Intensive Care Units, Pediatric
  • Intracranial Embolism (blood, diagnosis)
  • Intracranial Pressure (physiology)
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Monitoring, Physiologic (instrumentation)
  • Neuroblastoma (blood, diagnosis)
  • Oxygen (analysis)
  • Retrospective Studies
  • Sinus Thrombosis, Intracranial (blood, diagnosis)
  • Skull Base (injuries)
  • Skull Fractures (blood, diagnosis)
  • Stroke (blood, diagnosis)
  • Tomography, X-Ray Computed

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: