Variability of day-to-day pulsatility index change in children with cerebral malaria.

Autor:	Jordan J; University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States.; Children's of Alabama, Pediatric Critical Care, Birmingham, AL, United States., O'Brien N; Nationwide Children's Hospital, Columbus, OH, United States., Li P; University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States., Musungufu DA; Centre Medicale Evangelique (CME), Bunia, Democratic Republic of Congo., Ekandji RT; Universite des Sciences et des Technologie de Lodja (USTL), L'Hopital General de Reference de Lodja, Lodja, Democratic Republic of Congo., Mbaka JP; Universite des Sciences et des Technologie de Lodja (USTL), L'Hopital General de Reference de Lodja, Lodja, Democratic Republic of Congo., Mayindombe L; Cliniques Universitaires de Kinshasa, Hopital Pediatrique de Kalembe Lembe, Universite De Kinshasa, Kimwenza, Democratic Republic of Congo., Giresse B; Cliniques Universitaires de Kinshasa, Hopital Pediatrique de Kalembe Lembe, Universite De Kinshasa, Kimwenza, Democratic Republic of Congo., Phiri T; Queen Elizabeth Central Hospital, Blantyre, Malawi., June S; Queen Elizabeth Central Hospital, Blantyre, Malawi., Gushu Co MB; Queen Elizabeth Central Hospital, Blantyre, Malawi., Tshimanga T; Cliniques Universitaires de Kinshasa, Hopital Pediatrique de Kalembe Lembe, Universite De Kinshasa, Kimwenza, Democratic Republic of Congo., Reuter-Rice K; Duke University, School of Nursing, Durham, NC, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2024 Nov 11; Vol. 15, pp. 1466941. Date of Electronic Publication: 2024 Nov 11 (Print Publication: 2024).
DOI:	10.3389/fneur.2024.1466941
Abstrakt:	Introduction: Cerebral malaria (CM) is a devastating disease and better understanding of etiologies of the resulting neurologic injury is needed. The purpose of this study is to describe the day-to-day (DTD) pulsatility index (PI) change measured by transcranial Doppler ultrasound (TCD), a novel measure of cerebral and vascular changes, in children with CM. Methods: A retrospective analysis of 122 children in sub-Saharan Africa with CM and 3 or more sequential TCD measurements was performed. Variability of DTD PI change was calculated as a measure of changes in vasculature overtime. Neurologic outcome was determined by the Pediatric Cerebral Performance Category (PCPC) score, a measure of neurologic function. Results: Of the 122 participants, 77.9% had a good neurologic outcome (no neurologic sequelae), and 22.1% had a poor outcome (neurologic sequelae or died). Patients who had a poor neurologic outcome had higher levels of variability of DTD PI change in the right middle cerebral artery (MCA) (0.14 ± 0.21) and left MCA (0.17 ± 0.41) compared to those who had a good neurologic outcome (0.1 ± 0.1 and 0.11 ± 0.19, respectively). A higher variability of both left and right MCA DTD PI change was also associated with higher brain volume assessed through neuroimaging. Discussion: Variability of DTD PI change may provide early prognostic information regarding PCPC outcomes and brain volume changes seen in CM patients. Expanded research on pathophysiologic contributors to variability of DTD PI changes in children with CM is warranted. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Jordan, O’Brien, Li, Musungufu, Ekandji, Mbaka, Mayindombe, Giresse, Phiri, June, Gushu Co, Tshimanga and Reuter-Rice.)
Databáze:	MEDLINE
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