Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED

作者：Abramo Thomas J^*; Harris Z Leah; Meredith Mark; Crossman Kristen; Seupaul Rawle; Williams Abby; McMorrow Sheila; Dindo Jennifer; Gordon Angela; Melguizo Castro Maria; Hu Zhuopei; Nick Todd

来源：American Journal of Emergency Medicine, 2015, 33(11): 1622-1629.

DOI：10.1016/j.ajem.2015.07.037

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 < .0001). R(c)so(2) side differences in stroke alert and overall strokes were greater than in nonstrokes (P < .0001). Lower r(c)so(2) and CBVI correlated with both groups' stroke location, left (P < .0001) and right r(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 < .0001). For both groups, left r(c)so(2) and CBVI were greater than those of the right (P < .0001). Hemorrhagic strokes had lower bilateral rcso2 and CBVI than did ischemic strokes (P < .001).
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.

• 出版日期2015-11
• 单位西北大学