title: Change in cerebral autoregulation as a function of time in children after severe traumatic brain injury: a case series.
abstract: OBJECTIVE
  The objective of this study was to describe changes in cerebral autoregulation after severe pediatric traumatic brain injury (TBI).
  
  
  METHODS
  Two cerebral autoregulation tests were performed during the first 10 days after severe TBI in children <16 years. Cerebral autoregulation was quantified using the mean autoregulatory index (mARI).
  
  
  RESULTS
  Nine (five males/four females) children (10 +/- 5 years) with severe (admission Glasgow Coma Scale (GCS), 5 +/- 2) TBI were enrolled. Thirty (3/9) percent of initial exams revealed impaired cerebral autoregulation; all three had returned to intact cerebral autoregulation on second exam. However, in three of nine (33%) patients, cerebral autoregulation worsened on second exam. Of the factors examined, worsening mARI on second exam was associated with worsening head computed tomography (CT) lesion.
  
  
  CONCLUSIONS
  Cerebral autoregulation often changed and worsened during the first 9 days after severe pediatric TBI. Worsening cerebral autoregulation may mirror worsening TBI.
authors: Department of Anesthesiology, Harborview Medical Center, 325 Ninth Avenue, P.O. Box 359724, Seattle, WA 98104, USA.
authors: Nuj
authors: N
authors: Tontisirin
authors: William
authors: W
authors: Armstead
authors: Pichaya
authors: P
authors: Waitayawinyu
authors: Anne
authors: A
authors: Moore
authors: Yuthana
authors: Y
authors: Udomphorn
authors: Jerry J
authors: JJ
authors: Zimmerman
authors: Randall
authors: R
authors: Chesnut
authors: Monica S
authors: MS
authors: Vavilala
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology*; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D020768:Middle Cerebral Artery / Q000502:physiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide