Hemodynamics and Outcome in Pediatric Brain Injury

小儿脑损伤的血流动力学和结果

• 批准号: 6935188
• 负责人: Monica S Vavilala
• 金额: $ 12.61万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-01 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6935188
• 关键词: adolescence (12-20); age difference; blood pressure; brain circulation; brain injury; cerebral cortex; cerebral ischemia /hypoxia; child (0-11); clinical research; hemodynamics; hospital utilization; human subject; hypotension; neuropsychology; outcomes research; patient oriented research; pediatrics; questionnaires; reactive hyperemia; ultrasonography

DESCRIPTION (provided by applicant): Traumatic brain injury (TBI) is the leading cause of mortality in children over one year of age. Evidence suggests that hypotension after initial brain injury contributes to secondary brain injury and worsens outcome. Altered cerebral physiology including impaired cerebral autoregulation and hyperemia may also contribute to poor outcome following pediatric TBI. Therefore, characterizing optimal cerebral hemodynamics immediately following severe pediatric TBI is important. The objective of the proposed research is to describe the relationship between cerebral hemodynamics following severe pediatric TBI and outcome. The specific aims proposed here will provide new information regarding the early cerebral hemodynamic management of children with severe TBI. The aims are to examine (1) the relationship between cerebral perfusion pressure and outcome, (2) the relationship between persistent impairment of cerebral autoregulation and outcome, and (3) the age-related incidence of hyperemia. The investigators will also examine the relationship between hyperemia and impaired cerebral autoregulation and the relationship between persistent hyperemia and outcome following severe pediatric TBI. It is important to conduct these studies in children of various ages because (1) cerebral hemodynamics change significantly during development, (2) optimal cerebral hemodynamics following severe TBI may differ in young children compared to older children, (3) there is a paucity of physiologic data in children, and (4) pediatric practice is currently extrapolated from adult practice. The results and experience gained in this research will aid in the future study of cerebral hemodynamics in children at risk of cerebral ischemia both with and without TBI. The proposed research will be carried out at the University of Washington, well-known known for mentored patient-oriented research.

描述（由申请人提供）：创伤性脑损伤（TBI）是一岁以上儿童死亡的主要原因。有证据表明，初次脑损伤后的低血压会导致继发性脑损伤并使结果恶化。大脑生理学的改变，包括大脑自动调节受损和充血，也可能导致儿童 TBI 后的不良预后。因此，在严重的儿科 TBI 发生后立即表征最佳脑血流动力学非常重要。本研究的目的是描述严重儿科 TBI 后脑血流动力学与结果之间的关系。这里提出的具体目标将为严重 TBI 儿童的早期脑血流动力学管理提供新信息。目的是检查（1）脑灌注压与结果之间的关系，（2）脑自动调节持续受损与结果之间的关系，以及（3）与年龄相关的充血发生率。研究人员还将检查充血与大脑自动调节受损之间的关系，以及持续充血与严重儿童 TBI 后的结果之间的关系。在不同年龄的儿童中进行这些研究很重要，因为（1）脑血流动力学在发育过程中发生显着变化，（2）严重 TBI 后的最佳脑血流动力学在幼儿中可能与年龄较大的儿童不同，（3）缺乏儿童的生理数据，(4) 儿科实践目前是从成人实践推断出来的。这项研究的结果和经验将有助于未来研究有或没有 TBI 的脑缺血风险儿童的脑血流动力学。拟议的研究将在华盛顿大学进行，该大学以以患者为导向的研究而闻名。