Day-to-Day Change in Pulsatility Index Describes Anterior Cerebral Circulation Disturbance and Functional Outcomes in Pediatric Traumatic Brain Injury.
Journal
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
ISSN: 1945-2810
Titre abrégé: J Neurosci Nurs
Pays: United States
ID NLM: 8603596
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
pubmed:
2
9
2020
medline:
6
5
2021
entrez:
2
9
2020
Statut:
ppublish
Résumé
Traumatic brain injury (TBI) is a significant source of morbidity and mortality in children. Transcranial Doppler (TCD) ultrasound measures the cerebral arterial circulation allowing for the calculation of pulsatility indices (PIs) that provide an assessment of cerebral blood flow alterations. However, the use of PI in children with TBI is poorly understood and may be an important measure for the nursing care of children. The purpose of this article is to define day-to-day PI change and to describe its relationship to injury characteristics and functional outcomes in children with TBI. We performed a secondary analysis of a prospective observational parent study of 40 children aged 2 months to 15 years with mild or moderate-severe TBI who had serial TCDs. Sequential TCD PI measurements of day-to-day change revealed several consistencies among the TBI severity groups. Day-to-day PI change was higher in children with a moderate-severe injury (40%) when compared with those with a mild injury (21%). Greater day-to-day PI change was seen in children whose Glasgow Outcome Scale-Extended Pediatrics scores worsened (25%) compared with those who had an improved (19%) or unchanged (23%) scores. This study is the first to report day-to-day PI change in children with TBI and provides early insights into anterior cerebral artery circulation alterations of children with TBI. Although further research is needed, this study provides early evidence that TCD may be a valuable noninvasive neuromonitoring option in the management of children with TBI.
Sections du résumé
BACKGROUND
BACKGROUND
Traumatic brain injury (TBI) is a significant source of morbidity and mortality in children. Transcranial Doppler (TCD) ultrasound measures the cerebral arterial circulation allowing for the calculation of pulsatility indices (PIs) that provide an assessment of cerebral blood flow alterations. However, the use of PI in children with TBI is poorly understood and may be an important measure for the nursing care of children.
OBJECTIVES
OBJECTIVE
The purpose of this article is to define day-to-day PI change and to describe its relationship to injury characteristics and functional outcomes in children with TBI.
METHOD
METHODS
We performed a secondary analysis of a prospective observational parent study of 40 children aged 2 months to 15 years with mild or moderate-severe TBI who had serial TCDs. Sequential TCD PI measurements of day-to-day change revealed several consistencies among the TBI severity groups.
RESULTS
RESULTS
Day-to-day PI change was higher in children with a moderate-severe injury (40%) when compared with those with a mild injury (21%). Greater day-to-day PI change was seen in children whose Glasgow Outcome Scale-Extended Pediatrics scores worsened (25%) compared with those who had an improved (19%) or unchanged (23%) scores.
DISCUSSION
CONCLUSIONS
This study is the first to report day-to-day PI change in children with TBI and provides early insights into anterior cerebral artery circulation alterations of children with TBI. Although further research is needed, this study provides early evidence that TCD may be a valuable noninvasive neuromonitoring option in the management of children with TBI.
Identifiants
pubmed: 32868697
doi: 10.1097/JNN.0000000000000533
pmc: PMC7483877
mid: NIHMS1598047
pii: 01376517-202010000-00006
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
224-229Subventions
Organisme : NINR NIH HHS
ID : P30 NR014139
Pays : United States
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