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Abstract Details

Comparison of Invasive and Non-Invasive Brain Tissue Oximetry after Pediatric Traumatic Brain Injury
Neuro Trauma and Critical Care
P9 - Poster Session 9 (5:30 PM-6:30 PM)
1-005
 Traumatic brain injury (TBI) represents a major cause of morbidity and mortality for children.
In children with traumatic brain injury (TBI) undergoing invasive multimodality neurologic monitoring, we investigated whether changes in partial pressure of brain tissue oxygenation (PbtO2) are associated with changes in cerebral regional oximetry (RSO2), and whether changes in either measure of cerebral oximetry are similarly associated with changes in intracranial pressure (ICP), arterial blood pressure (ABP) or end-tidal carbon dioxide content (EtCO2).
Univariate dynamic structural equation modeling (DSEM) was utilized to investigate strength of association between rSO2 and PbtO2 at the subject level as well as in grouped analysis of 11 children with TBI. Multivariate DSEM was utilized to investigate the strength of association of rSO2 and PbtO2 to ABP, ICP and EtCO2, both on the subject level and through grouped analysis. 

Grouped analysis demonstrated a weak positive association between PbtO2 and rSO2 (SRC 0.04) with 6/11 patients demonstrating negative associations. With respect to ABP, grouped analysis revealed a positive association to PbtO2 (SRC 0.36) with all patients. Grouped analysis demonstrated a negative association with ABP and rSO2 (SRC -0.12), with 8/11 patients demonstrating negative associations. With respect to ICP, grouped analysis demonstrated a weak positive association with PbtO2 (SRC 0.01) with 6/11 patients demonstrating positive associations. Grouped analysis demonstrated a positive association between ICP and rSO2 (SRC 0.33) with 9/11 patients demonstrating positive associations. With respect to EtCO2, statistical significance was not observed with respect grouped analysis with PbtO2 with 7/11 patients demonstrating positive associations. Grouped analysis demonstrated a positive association between EtCO2 and rSO2 (SRC 0.20) with 8/11 patients demonstrating positive associations.

After pediatric TBI, associations between PbtO2 and rSO2, as well as their relationship to ICP, ABP and EtCO2 can be heterogenous. Further work is needed to clarify the clinical value of rSO2 monitoring.
Authors/Disclosures
Ann Oh (UCSF Pediatric Neurology Clinic)
PRESENTER
Dr. Oh has nothing to disclose.
M'hamed Temkit M'hamed Temkit has nothing to disclose.
Michael Kuwabara, MD Dr. Kuwabara has nothing to disclose.
P. David Adelson P. David Adelson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. P. David Adelson has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Adelson Medical Consulting. P. David Adelson has received publishing royalties from a publication relating to health care.
Brian L. Appavu, MD (Phoenix Children's Hospital) Dr. Appavu has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Natus. The institution of Dr. Appavu has received research support from American Heart Association. The institution of Dr. Appavu has received research support from United States Department of Defense.