title: Increased brain tissue oxygen tension in children with traumatic brain injury using temperature-corrected guided ventilation during prophylactic hypothermia.
abstract: OBJECTIVE
  To investigate whether ventilatory management using a temperature-corrected (pH-stat) or uncorrected (alpha-stat) blood gas analysis strategy improves brain tissue oxygen tension (PbrO(2)) in children prophylactically treated with moderate hypothermia for traumatic brain injury.
  
  
  METHODS
  Double crossover study conducted in the intensive care unit of a tertiary children's hospital. Nine children aged 3-14 years with severe traumatic brain injury were randomly allocated twice to a 6-hour period of either alpha- or pH-stat management while being kept hypothermic at 32.5°C.
  
  
  METHODS
  PbrO(2), intracranial pressure (ICP) and PbrO(2)/PaO(2).
  
  
  RESULTS
  PbrO(2) was significantly higher during pH-stat management (alpha-stat, 23.2mmHg [95% CI, 22.4- 24.0mmHg] v pH-stat, 28.7mmHg [95% CI, 27.9- 29.5mmHg]; P < 0.001). PbrO(2)/PaO(2) was significantly higher during pH-stat (alpha-stat, 0.190 [95% CI, 0.187- 0.193] v pH-stat, 0.251 [95% CI, 0.246-0.259]; P < 0.05). ICP was non-significantly higher during pH-stat (alpha-stat, 8.8mmHg [95% CI, 8.1-9.5mmHg] v ph-stat,10.2mmHg [95% CI, 9.6-10.8]).
  
  
  CONCLUSIONS
  PbrO(2) may be improved using a pH-stat blood gas management strategy in prophylactic hypothermia for paediatric patients with traumatic brain injury without any clinically relevant increase in ICP.
authors.affiliation: Mater Children's Hospital, Brisbane, QLD, Australia. andreas.schibler@mater.org.au
authors.forename: Andreas
authors.initials: A
authors.lastname: Schibler
authors.forename: Susan
authors.initials: S
authors.lastname: Humphreys
mesh_terms: D001315:Australia; D001784:Blood Gas Analysis; D001921:Brain / Q000378:metabolism; D001930:Brain Injuries / Q000097:blood / Q000378:metabolism* / Q000628:therapy*; D002560:Cerebrovascular Circulation; D002648:Child; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D010100:Oxygen / Q000097:blood / Q000378:metabolism; D010101:Oxygen Consumption; D010313:Partial Pressure; D012121:Respiration, Artificial / Q000379:methods*
chemical_list: D010100:Oxygen