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Cerebral rSO2 monitoring in pediatric altered mental status patients
Critical Care volume 17, Article number: P328 (2013)
Pediatric patients with altered mental status (AMS) present with poor histories resulting in delayed testing and potential poor outcomes. Non-invasive detection for altered cerebral physiology related to TBI would improve resuscitation and outcome. Cerebral rSO2 (rcSO2) studies demonstrate its utility in certain neurological emergencies.
A retrospective analysis of rcSO2 utility in AMS. rcSO2 data were collected every 30 seconds for AMS patients who had a head CT. Patients with a negative head CT were compared with those with an abnormal head CT. ROC analysis was performed to find the AUC for each summary statistic and performance characteristics. Subgroup analysis was done to determine whether rcSO2 predicted injury and location.
rcSO2 readings across 5, 15, 20, and 30 minutes were stable (Figure 1). rcSO2 readings with one or both sides <50% or a wide difference between L and R cerebrum was predictive of an abnormal CT scan. A mean difference of 4.2 was 82% sensitive for detecting a CT lesion with 62% specificity, 88% PPV, and 52% NPV; a mean difference of 12.2 was 100% specific for an abnormal head CT. Lower mean rcSO2 readings localized to the CT pathology side, and higher rcSO2 readings trend toward the EDH group.
Cerebral rcSO2 monitoring can non-invasively detect altered cerebral physiology and pathology related to TBI as the cause for pediatric altered mental status. The utility of rcSO2 monitoring has shown its potential for localizing and characterizing intracranial lesions among these altered children. Further studies utilizing rcSO2 monitoring as an adjunct tool in pediatric altered mental status evaluation and management are ongoing.
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Abramo, T., Kane, I. Cerebral rSO2 monitoring in pediatric altered mental status patients. Crit Care 17, P328 (2013). https://doi.org/10.1186/cc12266
- Pediatric Patient
- Summary Statistic
- Status Patient
- Altered Mental Status
- Wide Difference