Cerebral Oximetry for Detecting High-mortality Risk Patients with Cryptococcal Meningitis
| Autor: | Abdu K Musubire, David B. Meya, John W Diehl, Nicole Stephens, Mahsa Abassi, Astro-Cm Team, Katherine Huppler Hullsiek, David R. Boulware, Michael Okirwoth, Joshua Rhein |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
hemodynamic monitoring 03 medical and health sciences 0302 clinical medicine cryptococcal meningitis Interquartile range Internal medicine Major Article oximetry medicine 030212 general & internal medicine Cerebral perfusion pressure physiologic monitoring Intracranial pressure medicine.diagnostic_test Lumbar puncture business.industry 030208 emergency & critical care medicine Odds ratio medicine.disease mortality Confidence interval 3. Good health Pulse oximetry Infectious Diseases Oncology Cardiology cerebrovascular circulation business Meningitis |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| DOI: | 10.1093/ofid/ofy105 |
| Popis: | Background Cryptococcus is the commonest cause of adult meningitis in Africa, with 50%–70% experiencing increased intracranial pressure. Cerebral oximetry is a noninvasive near-infrared spectroscopy technology to monitor percent regional cerebral tissue oxygenation (rSO2). We assessed if cerebral oximetry predicts meningitis mortality. Methods We performed cerebral oximetry within 14 days of cryptococcal meningitis diagnosis on 121 Ugandans from April 2016 to September 2017. We evaluated baseline rSO2 association with mortality by multivariable logistic regression and correlation with other clinical factors. We compared groups formed by initial rSO2 Results The median initial rSO2 (interquartile range) was 36% (29%–42%), and it was Conclusions Individuals with cryptococcal meningitis and low cerebral oximetry (rSO2 < 30%) have high mortality. Cerebral oximetry may be useful as a prognostic marker of mortality. Targeted interventions to improve rSO2 should be tested in trials to try to decrease mortality in meningitis. |
| Databáze: | OpenAIRE |
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