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Author Kane, Ian ♦ Abramo, Thomas ♦ Meredith, Mark ♦ Williams, Abby ♦ Crossman, Kristen ♦ Wang, Wei ♦ Chandrasekhar, Rameela
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Nervous System Diseases ♦ Diseases ♦ Inorganic Chemicals ♦ Chemicals and Drugs ♦ Diagnosis ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons
Subject Keyword Discipline Emergency ♦ Discipline Medicine ♦ Consciousness Disorders ♦ Metabolism ♦ Craniocerebral Trauma ♦ Oxygen ♦ Child, Preschool ♦ Female ♦ Glasgow Coma Scale ♦ Humans ♦ Male ♦ Oximetry ♦ Pilot Projects ♦ Predictive Value Of Tests ♦ Sensitivity And Specificity ♦ Spectroscopy, Near-infrared ♦ Tomography, X-ray Computed ♦ Journal Article
Abstract OBJECTIVES: A pilot study assessing the potential utility of cerebral oximetry (local cerebral oxygen saturation [rcSO2]) in children presenting to the emergency department (ED) with altered mental status (AMS) and no history of trauma. METHODS: Patients who presented to a tertiary pediatric ED with AMS were monitored with left and right cerebral near-infrared spectroscopy probes and the first 30 minutes of rcSO2 data was analyzed. Patients with a history of trauma were excluded. Patients with an abnormal head computed tomography (CT) (n = 146) were compared with those with a negative head CT (n = 45). RESULTS: Mean rcSO2 values were consistent during each time period studied (5, 10, 20, and 30 minutes). In this study population, rcSO2 less than 50% or greater than 80% and increased absolute difference between the left and right rcSO2 measurements were associated with an abnormal CT scan. A difference of 12.2% between the left and right rcSO2 values had a 100% positive predictive value for an abnormal head CT among our patients. Cumulative graphical plots of rcSO2 trends showed that values <50% were associated with subdural hematomas (SDH) and values >80% were associated with epidural hematomas (EDH). CONCLUSIONS: This study demonstrated that cerebral oximetry can noninvasively detect altered cerebral physiology among a selected patient population. The difference between the left and right rcSO2 readings most reliably identified those subjects with altered cerebral physiology. In the future, rcSO2 monitoring has the potential to be used as a screening tool to identify, localize, and characterize intracranial injuries among children with AMS without a history of trauma.
Description Author Affiliation: Kane I ( Pediatric Emergency Medicine, Vanderbilt Children's Hospital, Nashville, TN, USA. Electronic address: ian.d.kane@vanderbilt.edu.); Abramo T ( Arkansas Children's Hospital, Little Rock, AR 72202, USA. Electronic address: TAbramo@uams.edu.); Meredith M ( Pediatric Emergency Medicine, Vanderbilt Children's Hospital, Nashville, TN, USA.); Williams A ( Pediatric Emergency Medicine, Vanderbilt Children's Hospital, Nashville, TN, USA.); Crossman K ( Pediatric Emergency Medicine, Vanderbilt Children's Hospital, Nashville, TN, USA.); Wang W ( Department of Biostatistics, Vanderbilt University, Nashville, TN, USA.); Chandrasekhar R ( Department of Biostatistics, Vanderbilt University, Nashville, TN, USA.)
ISSN 07356757
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2014-04-01
Publisher Place United States
e-ISSN 15328171
Journal The American Journal of Emergency Medicine
Volume Number 32
Issue Number 4


Source: WHO-Global Index Medicus