Deviations from NIRS-derived optimal blood pressure are associated with worse outcomes after pediatric cardiac arrest.
Cardiac arrest
Cerebral autoregulation
Cerebrovascular autoregulation
Hypoxic ischemic brain injury
NIRS
Pediatrics
Journal
Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
09
08
2021
revised:
17
09
2021
accepted:
20
09
2021
pubmed:
3
10
2021
medline:
3
11
2021
entrez:
2
10
2021
Statut:
ppublish
Résumé
Evaluate cerebrovascular autoregulation (CAR) using near-infrared spectroscopy (NIRS) after pediatric cardiac arrest and determine if deviations from CAR-derived optimal mean arterial pressure (MAP CAR was quantified by a moving, linear correlation between time-synchronized mean arterial pressure (MAP) and regional cerebral oxygenation, called cerebral oximetry index (COx). MAP Thirty-four children (median age 2.9 [IQR 1.5,13.4] years) were evaluated. Median COx in the first 24 h post-cardiac arrest was 0.06 [0,0.20]; patients spent 27% [19,43] of monitored time with COx ≥ 0.3. Patients with an unfavorable outcome (n = 24) had a greater difference between MAP and MAPopt - 5 (13 [11,19] vs. 9 [8,10] mmHg, p = 0.01) and spent more time with MAP below MAPopt - 5 (38% [26,61] vs. 24% [14,28], p = 0.03). Patients with unfavorable outcome had a higher burden of MAP less than MAPopt - 5 than patients with favorable outcome in the first 24 h post-arrest (187 [107,316] vs. 62 [43,102] mmHg × Min/Hr; OR 4.93 [95% CI 1.16-51.78]). Greater burden of MAP below NIRS-derived MAPopt - 5 during the first 24 h after cardiac arrest was associated with unfavorable outcomes.
Identifiants
pubmed: 34600027
pii: S0300-9572(21)00377-4
doi: 10.1016/j.resuscitation.2021.09.023
pmc: PMC9150719
mid: NIHMS1808004
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
110-118Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL148541
Pays : United States
Organisme : NINDS NIH HHS
ID : K23 NS116120
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier B.V. All rights reserved.
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