PMID: 11904028Mar 21, 2002Paper

Cerebral extraction of oxygen and intracranial hypertension in severe, acute, pediatric brain trauma: preliminary novel management strategies

Neurosurgery
J CruzGina Valéria F Giorgetti

Abstract

To evaluate long-term clinical outcomes after severe, acute, pediatric brain trauma, in relation to cerebral extraction of oxygen (CEO(2)) and intracranial pressure abnormalities treated with a protocol to simultaneously normalize both parameters. Forty-five acutely comatose children who had sustained severe, non-missile brain trauma were prospectively evaluated and treated according to a protocol to maintain normalized values not only for intracranial pressure and perfusion pressure but also for CEO(2) (the arteriojugular oxyhemoglobin saturation difference). Six-month clinical outcomes were assessed in relation to physiological abnormalities observed during the acute phase of injury. At 6 months after injury, 37 children (82.2%) had achieved favorable clinical outcomes, whereas eight children (17.8%) had not. The mortality rate was 4.4% (two children only). For the overall series, intracranial hypertension was closely associated with the development of relative cerebral hyperperfusion (decreased CEO(2)), especially after postinjury Day 1. A comparison of data for children with favorable versus unfavorable clinical outcomes revealed statistically significant between-group differences for high intracranial pressure and low CEO(...Continue Reading

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Citations

Oct 5, 2006·Current Opinion in Anaesthesiology·Roman Hlatky, Claudia S Robertson
Oct 24, 2006·Arquivos de neuro-psiquiatria·Rodrigo Moreira FaleiroSebastião Gusmão
Mar 5, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Patrick M KochanekMark S Wainwright
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Nov 26, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ursula K Rohlwink, Anthony A Figaji
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Oct 31, 2017·Pediatric Research·Adam M H YoungPeter J Hutchinson
Mar 5, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Patrick M KochanekMark S Wainwright
Feb 6, 2020·Frontiers in Neurology·Sarah Hornshøj PedersenMarianne Juhler
Nov 25, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kendra S WoodsAlicia K Au

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