Skip to main content

Cerebral rSO2 monitoring in pediatric altered mental status patients

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

Figure 1
figure1

abstractp328

Author information

Affiliations

Authors

Corresponding author

Correspondence to T Abramo.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Abramo, T., Kane, I. Cerebral rSO2 monitoring in pediatric altered mental status patients. Crit Care 17, P328 (2013). https://doi.org/10.1186/cc12266

Download citation

Keywords

  • Pediatric Patient
  • Summary Statistic
  • Status Patient
  • Altered Mental Status
  • Wide Difference