Vavilala M S, Muangman S, Tontisirin Nuj, Fisk D, Roscigno C, Mitchell P, Kirkness C, Zimmerman J J, Chesnut Randall, Lam A M
Department of Anesthesiology, University of Washington, Seattle, WA 98104, USA.
Dev Neurosci. 2006;28(4-5):348-53. doi: 10.1159/000094161.
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<or=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.
本研究的目的是描述小儿严重创伤性脑损伤(TBI)后大脑自动调节功能受损的发生率,并描述大脑自动调节功能受损与预后之间的关系。我们前瞻性地检查了28名年龄≤17岁(10±5岁)、在儿科重症监护病房入院后72小时内格拉斯哥昏迷量表评分<9分的儿童的大脑自动调节功能。排除单纯局灶性TBI患儿。在出院时以及严重TBI后3个月和6个月收集格拉斯哥预后评分(GOS)。GOS<4表示预后不良。28名儿童中有12名大脑自动调节功能受损。自动调节指数<0.4与6个月时GOS<4相关(p=0.005)。小儿严重TBI后早期大脑自动调节功能受损与6个月预后不良相关。