Change in cerebral autoregulation as a function of time in children after severe traumatic brain injury: a case series

Tontisirin, Nuj; Armstead, William M.; Waitayawinyu, Pichaya; Moore, Anne; Udomphorn, Yuthana; Zimmerman, Jerry J.; Chesnut, Randall M.; Vavilala, Monica S.

doi:10.1007/s00381-007-0339-0

Cited by 39 publications

(18 citation statements)

References 20 publications

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“…Our study of moderate to severe pediatric TBI shows that hemispheric differences in cerebral autoregulation are common (40%) after focal TBI, and that, cerebral autoregulation may be impaired in those hemispheres without radiographic evidence of TBI (unpublished data). Furthermore, a recent study of severe pediatric TBI reported that cerebral autoregulation often changed and worsened during the first 9 days after injury, and that worsening cerebral autoregulation may mirror worsening TBI [105].…”

Section: Impaired Cerebral Pressure Autoregulationmentioning

confidence: 99%

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Udomphorn

Armstead

Vavilala

2008

Pediatric Neurology

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133

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Traumatic brain injury is a global health concern and is the leading cause of traumatic morbidity and mortality in children. Despite a lower overall mortality than in adult traumatic brain injury, the cost to society from the sequelae of pediatric traumatic brain injury is very high. Predictors of poor outcome after traumatic brain injury include altered systemic and cerebral physiology, including altered cerebral hemodynamics. Cerebral autoregulation is often impaired following traumatic brain injury and may adversely impact poor outcome. Although altered cerebrovascular hemodynamics early after traumatic brain injury may contribute to disability in children, there is a paucity of information regarding changes in cerebral blood flow and cerebral autoregulation after pediatric traumatic brain injury. In this article, we discuss normal pediatric cerebral physiology and cerebrovascular pathophysiology following pediatric traumatic brain injury.

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Section: Impaired Cerebral Pressure Autoregulationmentioning

confidence: 99%

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Udomphorn

Armstead

Vavilala

2008

Pediatric Neurology

Self Cite

133

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“…Impaired cerebral autoregulation is common following TBI and has been reported in 29 to 63% of pediatric patients [60][61][62][63]. Young age (less than 5 years) appears to be a risk factor [64,65].…”

Section: Current Controversiesmentioning

confidence: 99%

Pediatric Neurocritical Care

Murphy

2012

Neurotherapeutics

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Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.

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“…During the first 0-9 days cerebral autoregulation is often impaired following a TBI, this results in CBF becoming dependent on cerebral perfusion pressures (CPP) and ICP (Tontisirin et al, 2007). An increased risk for impaired autoregulation has been associated with increased ICP, hyperemia, decreased hematocrit, decreased arterial oxygen (PaO 2 ), increased cerebral lesion size, and are less than 4 years of age (Freeman, Udomphorn, Armstead, Fisk, & Vavilala, 2008;Tontisirin et al, 2007). Clinically, children with impaired cerebral autoregulation have increased odds of poor outcomes (e.g., functional impairment, vegetative state, or death) (Tontisirin et al, 2007).…”

Section: Secondary Injurymentioning

confidence: 99%

Pathophysiology and Treatment of Severe Traumatic Brain Injuries in Children

2016

Journal of Neuroscience Nursing

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Change in cerebral autoregulation as a function of time in children after severe traumatic brain injury: a case series

Abstract: Cerebral autoregulation often changed and worsened during the first 9 days after severe pediatric TBI. Worsening cerebral autoregulation may mirror worsening TBI.

Cited by 39 publications

References 20 publications

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Pediatric Neurocritical Care

Pathophysiology and Treatment of Severe Traumatic Brain Injuries in Children

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