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，初始脑损伤后的低血压会导致继发性脑损伤并恶化。大脑生理的改变，包括脑自动调节受损和充血性疾病，也可能导致小儿TBI后不良预后。因此，在严重的小儿TBI之后，立即表征最佳的脑血液动力学很重要。拟议研究的目的是描述严重的小儿TBI和结果后脑血液动力学之间的关系。此处提出的具体目的将提供有关严重TBI儿童早期脑血液动力学管理的新信息。目的是检查（1）脑灌注压力与结局之间的关系，（2）脑自动调节和结果持续损害之间的关系，以及（3）与体内充血的年龄相关的发生率。研究人员还将检查充血与脑自动调节受损的关系以及严重的小儿TBI后持续性充血与结局之间的关系。重要的是在各个年龄的儿童中进行这些研究很重要，因为（1）在发育过程中脑血液动力学发生了显着变化，（2）严重TBI后的最佳脑血流动力学在幼儿中可能有所不同，与年龄较大的儿童相比，（3）儿童的生理数据很少，并且（4）目前在成年成人中表达了儿童实践。这项研究中获得的结果和经验将有助于未来对有和没有TBI的脑缺血风险的儿童的脑血液动力学研究。拟议的研究将在华盛顿大学进行，以指导的以患者为导向的研究闻名。