Portal de investigação
Cardiovascular responses as predictors of mortality in children with acute brain injury
Autores da FMUP
Participantes de fora da FMUP
- Silva M.J.
- Gonçalves H.
- Almeida R.
- Dias C.C.
- Almeida A.I.
- Rocha A.P.
- Granja C.
- Baptista M.J.
Unidades de investigação
Abstract
Background: Investigate the utility of cardiovascular responses such as heart rate (HR), blood pressure (BP), and heart rate variability (HRV) in the prognosis of children with acute acquired brain injury (ABI). Methods: Children under 18 years with severe acute acquired brain injury (ABI) who survived at least 12 h after PICU admission were included in a prospective observational cohort in a tertiary academic PICU. Physiological variables, neurological data, laboratory tests (chemistry and hematology), and medications were recorded within 12 h of admission. Linear and nonlinear HRV indices, CT scans, PICU scores, and survival rates were evaluated. Results: Seventy-two children, median age 10.7 years (IQR 4.1–13.6), were eligible for the study; 28 (38.9%) were diagnosed with brain death (BD). Tachycardia, SBP and MBP < 5th percentile, and MBP and DBP> 99th percentile were significantly associated with mortality. Poincaré SD1/SD2 was significantly associated with mortality after adjusting for age, sex and ongoing medication. Conclusion: Tachycardia, systolic hypotension and median hypo and hypertension were associated to mortality in children with severe ABI. While further validation through larger, multicenter studies is necessary, the Poincaré SD1/SD2 ratio has shown promise as a prognostic tool for predicting mortality in children with severe ABI. Impact statement: This study explores cardiovascular changes, including heart rate and blood pressure, and linear/nonlinear HRV measures using ECG at 1000 Hz, and compare them with other prognostic factors like brain tomography and PICU scores. Tachycardia, hypo/hypertension in the early hours after admission are linked to early mortality in children with severe traumatic and non-traumatic brain injury. Linear/non-linear measures of HRV were also related to survival. Higher HRV values indicating better survival chances. We identified Poincaré SD1/SD2 ratio as a promising tool for predicting mortality in children with severe ABI. © The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2024.
Dados da publicação
- ISSN/ISSNe:
- 0031-3998, 1530-0447
- Tipo:
- Article
- Páginas:
- -
- PubMed:
- 39548295
- Link para outro recurso:
- www.scopus.com
Pediatric Research Lippincott Williams and Wilkins Ltd.
Citações Recebidas na Web of Science: 2
Citações Recebidas na Scopus: 4
Documentos
- Não há documentos
Filiações
Keywords
- HEART-RATE-VARIABILITY; APPROXIMATE ENTROPY; DEATH; SCALE
Financiamento
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Citar a publicação
Silva MJ,Gonçalves H,Almeida R,Dias CC,Almeida AI,Rocha AP,Granja C,Baptista MJ,Azevedo I. Cardiovascular responses as predictors of mortality in children with acute brain injury. Pediatr. Res. 2024. IF:3,600. (1).
