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Ermolenko K.Yu.

Children’s Research Clinical Center for Infectious Diseases;
St. Petersburg State Pediatric Medical University

Pshenisnov K.V.

Children’s Scientific Clinical Center for Infectious Diseases

Aleksandrovich Yu.S.

Children’s Scientific Clinical Center for Infectious Diseases

Vasilieva Yu.P.

Children’s Research Clinical Center for Infectious Diseases

Cerebral perfusion in children with severe infections of the central nervous system

Authors:

Ermolenko K.Yu., Pshenisnov K.V., Aleksandrovich Yu.S., Vasilieva Yu.P.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2023;(5): 32‑39

DOI: 10.17116/anaesthesiology202305132

Read: 3297 times

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Table of contents

CEREBRAL PERFUSION IN CHILDREN WITH SEVERE INFECTIONS OF THE CENTRAL NERVOUS SYSTEM
CEREBRAL PERFUSION IN CHILDREN WITH SEVERE INFECTIONS OF THE CENTRAL NERVOUS SYSTEM

To cite this article:

Ermolenko KYu, Pshenisnov KV, Aleksandrovich YuS, Vasilieva YuP. Cerebral perfusion in children with severe infections of the central nervous system. Russian Journal of Anesthesiology and Reanimatology. 2023;(5):32‑39. (In Russ., In Engl.)
https://doi.org/10.17116/anaesthesiology202305132

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Abstract:

BACKGROUND

Adequate cerebral perfusion is a major challenge in ICU children with severe infections of the central nervous system (CNS).

OBJECTIVE

To establish the optimal indicators of systemic and cerebral perfusion in children with CNS infections and catecholamine support.

MATERIAL AND METHODS

There were 100 children aged 3.5±2.6 years with severe CNS infections. GCS score at admission was 8.8±2.4 points. To assess the effectiveness of cerebral perfusion, we measured optic nerve diameter and performed transcranial Doppler neurosonography with calculation of resistance index in the middle cerebral artery. Oxygen saturation in brain parenchyma was assessed in 30 patients by using of cerebral oximetry. We measured transverse dimensions of hemispheres and lateral ventricles in all patients. All examinations were conducted in 1, 3 and 5 days after admission to ICU.

RESULTS

The only significant indicator was resistance index in the middle cerebral artery. This value was significantly higher in deceased patients (0.65±0.11 vs 0.48±0.16; p<0.05). A correlation between optic disc diameter and GCS score was revealed (R=0.52; p<0.005). Severity of cardiovascular dysfunction correlated with resistance index in the middle cerebral artery (R=0.61; p<0.005). Optic disc diameter was not associated with outcomes of disease. Optimal cerebral perfusion is observed in patients with mean blood pressure 55—75 mm Hg.

CONCLUSION

Mean blood pressure should be maintained within 55—75 mm Hg in children with severe CNS infections requiring hemodynamic support.

Keywords:

CNS infections
children
intracranial hypertension
cerebral perfusion

Authors:

Ermolenko K.Yu.

Children’s Research Clinical Center for Infectious Diseases;
St. Petersburg State Pediatric Medical University

Pshenisnov K.V.

Children’s Scientific Clinical Center for Infectious Diseases

Aleksandrovich Yu.S.

Children’s Scientific Clinical Center for Infectious Diseases

Vasilieva Yu.P.

Children’s Research Clinical Center for Infectious Diseases

Received:

31.01.2023

Accepted:

28.03.2023

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