CBF and CBF/PCO2 reactivity in childhood strangulation. Export

@article{citeulike:3025236, abstract = {Four children with self-inflicted strangulation injuries had cerebral blood flow determined by stable xenon computed tomography (XeCTCBF) within 24 hours of admission. All had suffered a severe hypoxic-ischemic cerebral injury; 3 initially had fixed pupils, all were apneic with varying bradyarrhythmias, and the initial mean arterial pH was 7.26 (+/- 0.18). The initial blood glucose values were greater than 300 mg/dl (334 and 351 mg/dl) in the 2 patients who died compared to the 2 who survived (104 and 295 mg/dl). The cardiac index was depressed during the first several days of hospitalization in the 2 patients who died (less than 2.0 L/min/m2) compared to the 2 who survived. Total CBF was normal (63 +/- 8 ml/min/100 gm) and local variations in CBF were present. PCO2 reactivity was determined by hyperventilating the 4 patients for 20 min from an end tidal PCO2 of 39 +/- 3 torr to 29 +/- 1 torr and then repeating the XeCTCBF study. Marked regional variability in the CBF/PCO2 response was observed, ranging from 0.5-5.5 ml/min/100 gm/torr PCO2. In the 2 patients who died, the CBF/PCO2 was decreased (1.2 ml/min/100 gm/torr PCO2) compared to the 2 patients who survived (2.1 ml/min/100 gm/torr PCO2). Although CBF was normal in these 4 children, the hyperventilation response was depressed, variable, and even paradoxical which may be important in the evolution of further brain injury and is a critical factor in deciding whether hyperventilation may be of clinical benefit.(ABSTRACT TRUNCATED AT 250 WORDS)}, address = {Department of Pediatrics, Loma Linda University School of Medicine, California 92350.}, author = {Ashwal, S. and Perkin, R. M. and Thompson, J. R. and Tomasi, L. G. and van Stralen, D. and Schneider, S.}, citeulike-article-id = {3025236}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/1764140}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=1764140}, issn = {0887-8994}, journal = {Pediatric neurology}, keywords = {allages, cbf, children, hypercapnia, neonatal, neonates, strangulation, vasoreactivity}, number = {5}, pages = {369--374}, posted-at = {2008-07-21 20:05:58}, priority = {2}, title = {CBF and CBF/PCO2 reactivity in childhood strangulation.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/1764140}, volume = {7}, year = {1991} }

TY - JOUR ID - citeulike:3025236 L3 - citeulike-article-id:3025236 N2 - Four children with self-inflicted strangulation injuries had cerebral blood flow determined by stable xenon computed tomography (XeCTCBF) within 24 hours of admission. All had suffered a severe hypoxic-ischemic cerebral injury; 3 initially had fixed pupils, all were apneic with varying bradyarrhythmias, and the initial mean arterial pH was 7.26 (+/- 0.18). The initial blood glucose values were greater than 300 mg/dl (334 and 351 mg/dl) in the 2 patients who died compared to the 2 who survived (104 and 295 mg/dl). The cardiac index was depressed during the first several days of hospitalization in the 2 patients who died (less than 2.0 L/min/m2) compared to the 2 who survived. Total CBF was normal (63 +/- 8 ml/min/100 gm) and local variations in CBF were present. PCO2 reactivity was determined by hyperventilating the 4 patients for 20 min from an end tidal PCO2 of 39 +/- 3 torr to 29 +/- 1 torr and then repeating the XeCTCBF study. Marked regional variability in the CBF/PCO2 response was observed, ranging from 0.5-5.5 ml/min/100 gm/torr PCO2. In the 2 patients who died, the CBF/PCO2 was decreased (1.2 ml/min/100 gm/torr PCO2) compared to the 2 patients who survived (2.1 ml/min/100 gm/torr PCO2). Although CBF was normal in these 4 children, the hyperventilation response was depressed, variable, and even paradoxical which may be important in the evolution of further brain injury and is a critical factor in deciding whether hyperventilation may be of clinical benefit.(ABSTRACT TRUNCATED AT 250 WORDS) IS - 5 JF - Pediatric neurology SN - 0887-8994 AD - Department of Pediatrics, Loma Linda University School of Medicine, California 92350. EP - 374 TI - CBF and CBF/PCO2 reactivity in childhood strangulation. VL - 7 SP - 369 KW - allages KW - cbf KW - children KW - hypercapnia KW - neonatal KW - neonates KW - strangulation KW - vasoreactivity AU - Ashwal, S AU - Perkin, RM AU - Thompson, JR AU - Tomasi, LG AU - van Stralen, D AU - Schneider, S PY - 1991///t UR - http://view.ncbi.nlm.nih.gov/pubmed/1764140 ER -