Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED
| Autor: | Kristen Crossman, Jennifer Dindo, Zhuopei Hu, Abby Williams, Z. Leah Harris, Angela Gordon, Rawle A. Seupaul, Mark Meredith, Sheila P. McMorrow, Todd G. Nick, Thomas J. Abramo, Maria Melguizo-Castro |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Adolescent Blood volume Cerebral oxygen saturation Predictive Value of Tests medicine Pediatric stroke Health Status Indicators Humans cardiovascular diseases Oximetry Prospective Studies Prospective cohort study Child Stroke Cerebral oximetry Blood Volume business.industry General Medicine medicine.disease Oxygen Cerebral blood volume Predictive value of tests Anesthesia Cerebrovascular Circulation Emergency Medicine Female business Biomarkers |
| Zdroj: | The American journal of emergency medicine. 33(11) |
| ISSN: | 1532-8171 |
| Popis: | Background Despite pediatric stroke awareness and pediatric stroke activation systems, recognition and imaging delays along with activation inconsistency still occur. Reliable objective pediatric stroke detection tools are needed to improve detection and activations. Regional cerebral oxygen saturation (r c so 2 ) with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology. Objective To determine cerebral oximetry in detecting strokes in stroke alert and overall stroke patients. Method Left r c so 2 , right r c so 2 , and r c so 2 side differences for stroke, location, and types were analyzed. Results Compared with stroke alert (n = 25) and overall strokes (n = 52), r c so 2 and CBVI were less than those in nonstrokes (n = 133; P c so 2 side differences in stroke alert and overall strokes were greater than in nonstrokes ( P c so 2 and CBVI correlated with both groups' stroke location, left ( P c so 2 ( P = .004). R c so 2 differences greater than 10 had a 100% positive predictive value for stroke. Both groups' r c so 2 and CBVI side differences were consistent for stroke location and type ( P c so 2 and CBVI were greater than those of the right ( P c so 2 and CBVI than did ischemic strokes ( P Conclusions Cerebral oximetry and CBVI detected abnormal cerebral physiology, stroke location, and type (hemorrhagic or ischemic). R c so 2 side differences greater than 10 or r c so 2 readings less than 50% had a 100% positive predictive value for stroke. Cerebral oximetry has shown potential as a detection tool for stroke location and type in a pediatric stroke alert and nonalert stroke patients. Using cerebral oximetry by the nonneurologist, we found that the patient's r c so 2 side difference greater than 10 or one or both sides having less than 50% r c so 2 readings suggests abnormal hemispheric pathology and expedites the patient's diagnosis, neuroresuscitation, and radiologic imaging. |
| Databáze: | OpenAIRE |
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