ArticleNeurocritical care2021
Multimodal Assessment of Cerebral Autoregulation and Autonomic Function After Pediatric Cerebral Arteriovenous Malformation Rupture.
Article in Neurocritical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Cerebral autoregulation in pediatric and neonatal intensive care: A scoping review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Cerebral autoregulation, spreading depolarization, and implications for targeted therapy in brain injury and ischemia.Reviews in the neurosciences · 2024Review
- Neuromonitoring in Pediatric Neurocritical Care: An Introduction.Neurocritical care · 2024Article
- The State of the Field of Pediatric Multimodality Neuromonitoring.Neurocritical care · 2024Review
- Neurophysiologic Features Reflecting Brain Injury During Pediatric ECMO Support.Neurocritical care · 2024Observational
- Changes in autonomic function and cerebral and somatic oxygenation with arterial flow pulsatility for children requiring veno-arterial extracorporeal membrane oxygenation.Brain & spine · 2024Article
- Approaches to neuroprotection in pediatric neurocritical care.World journal of critical care medicine · 2023Review
- Neuromonitoring in Children with Cerebrovascular Disorders.Neurocritical care · 2023Review
- Invasive Neuromonitoring Modalities in the Pediatric Population.Neurocritical care · 2023Review
- Exploring Trends in Neuromonitoring Use in a General Pediatric ICU: The Need for Standardized Guidance.Children (Basel, Switzerland) · 2022Article
- Multimodal Neurologic Monitoring in Children With Acute Brain Injury.Pediatric neurology · 2022Review
- A Survey of Neuromonitoring Practices in North American Pediatric Intensive Care Units.Pediatric neurology · 2022Article
- Association of Outcomes with Model-Based Indices of Cerebral Autoregulation After Pediatric Traumatic Brain Injury.Neurocritical care · 2021Article
- Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManagement after cerebral arteriovenous malformation (AVM) rupture aims toward preventing hemorrhagic expansion while maintaining cerebral perfusion to avoid secondary injury. We investigated associations of model-based indices of cerebral autoregulation (CA) and autonomic function (AF) with outcomes after pediatric cerebral AVM rupture.
methodsMultimodal neurologic monitoring data from the initial 3 days after cerebral AVM rupture were retrospectively analyzed in children (< 18 years). AF indices included standard deviation of heart rate (HRsd), root-mean-square of successive differences in heart rate (HRrmssd), low-high frequency ratio (LHF), and baroreflex sensitivity (BRS). CA indices include pressure reactivity index (PRx), wavelet pressure reactivity indices (wPRx and wPRx-thr), pulse amplitude index (PAx), and correlation coefficient between intracranial pressure pulse amplitude and cerebral perfusion pressure (RAC). Percent time of cerebral perfusion pressure (CPP) below lower limits of autoregulation (LLA) was also computed for each CA index. Primary outcomes were determined using Pediatric Glasgow Outcome Score Extended-Pediatrics (GOSE-PEDs) at 12 months and acquired epilepsy. Association of biomarkers with outcomes was investigated using linear regression, Wilcoxon signed-rank, or Chi-square.
resultsFourteen children were analyzed. Lower AF indices were associated with poor outcomes (BRS [p = 0.04], HRsd [p = 0.04], and HRrmssd [p = 0.00]; and acquired epilepsy (LHF [p = 0.027]). Higher CA indices were associated with poor outcomes (PRx [p = 0.00], wPRx [p = 0.00], and wPRx-thr [p = 0.01]), and acquired epilepsy (PRx [p = 0.02] and wPRx [p = 0.00]). Increased time below LLA was associated with poor outcome (percent time below LLA based on PRx [p = 0.00], PAx [p = 0.04], wPRx-thr [p = 0.03], and RAC [p = 0.01]; and acquired epilepsy (PRx [p = 0.00], PAx [p = 0.00], wPRx-thr [p = 0.03], and RAC [p = 0.01]).
conclusionsAfter pediatric cerebral AVM rupture, poor outcomes are associated with AF and CA when applying various neurophysiologic model-based indices. Prospective work is needed to assess these indices of CA and AF in clinical decision support.
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