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Monitoring cerebrovascular reactivity in pediatric traumatic brain injury: comparison of three methods

2021Journal article Restricted access
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dc.contributor.authorAbecasis, Francisco
dc.contributor.authorDias, Celeste
dc.contributor.authorZakrzewska, Agnieszka
dc.contributor.authorOliveira, Victor
dc.contributor.authorCzosnyka, Marek
dc.date.accessioned2022-09-21T15:06:49Z
dc.date.available2022-09-21T15:06:49Z
dc.date.issued2021
dc.description© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021pt_PT
dc.description.abstractPurpose: To study three different methods of monitoring cerebral autoregulation in children with severe traumatic brain injury. Methods: Prospective cohort study of all children admitted to the pediatric intensive care unit at a university-affiliated hospital with severe TBI over a 4-year period to study three different methods of monitoring cerebral autoregulation: pressure-reactivity index (PRx), transcranial Doppler derived mean flow velocity index (Mx), and near-infrared spectroscopy derived cerebral oximetry index (COx). Results: Twelve patients were included in the study, aged 5 months to 17 years old. An empirical regression analyzing dependence of PRx on cerebral perfusion pressure (CPP) displayed the classic U-shaped distribution, with low PRx values (< 0.3) reflecting intact auto-regulation, within the CPP range of 50-100 mmHg. The optimal CPP was 75-80 mmHg for PRx and COx. The correlation coefficients between the three indices were as follows: PRx vs Mx, r = 0.56; p < 0.0001; PRx vs COx, r = 0.16; p < 0.0001; and COx vs Mx, r = 0.15; p = 0.022. The mean PRx with a cutoff value of 0.3 predicted correctly long-term outcome (p = 0.015). Conclusions: PRx seems to be the most robust index to access cerebrovascular reactivity in children with TBI and has promising prognostic value. Optimal CPP calculation is feasible with PRx and COx.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationChilds Nerv Syst. 2021 Oct;37(10):3057-3065pt_PT
dc.identifier.doi10.1007/s00381-021-05263-zpt_PT
dc.identifier.issn0256-7040
dc.identifier.issn1433-0350
dc.identifier.urihttp://hdl.handle.net/10451/54547
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Naturept_PT
dc.relation.publisherversionhttps://www.springer.com/journal/381pt_PT
dc.subjectCerebral perfusion pressurept_PT
dc.subjectCerebrovascular circulationpt_PT
dc.subjectIntracranial pressurept_PT
dc.subjectPediatricspt_PT
dc.subjectTraumatic brain injurypt_PT
dc.titleMonitoring cerebrovascular reactivity in pediatric traumatic brain injury: comparison of three methodspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage3065pt_PT
oaire.citation.issue10pt_PT
oaire.citation.startPage3057pt_PT
oaire.citation.titleChild's Nervous Systempt_PT
oaire.citation.volume37pt_PT
person.familyNameAbecasis
person.familyNameOliveira
person.givenNameFrancisco
person.givenNameVitor
person.identifier.orcid0000-0002-1883-050X
person.identifier.orcid0000-0001-8483-8596
person.identifier.ridM-1875-2013
person.identifier.scopus-author-id52464128000
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication6bc18a15-8c0b-43a5-a5ca-1965fcfd27b5
relation.isAuthorOfPublication0cf3b12b-5c11-4723-842f-72899e104c33
relation.isAuthorOfPublication.latestForDiscovery0cf3b12b-5c11-4723-842f-72899e104c33

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