Depression of whole-brain oxygen extraction fraction is associated with poor outcome in pediatric traumatic brain injury

Pediatr Res. 2012 Feb;71(2):199-204. doi: 10.1038/pr.2011.31. Epub 2011 Dec 21.

Abstract

Introduction: Traumatic brain injury (TBI) is a leading cause of death and disability in children. Metabolic failure is an integral component of the pathological aftermath of TBI. The oxygen extraction fraction (OEF) is a valuable parameter for characterization and description of metabolic abnormalities; however, OEF measurement has required either invasive procedures or the use of ionizing radiation, which significantly limits its use in pediatric research.

Results: Patients with TBI had depressed OEF levels that correlated with the severity of injury. In addition, the OEF measured within 2 weeks of injury was predictive of patient outcome at 3 mo after injury. In pediatric TBI patients, low OEF-a marker of metabolic dysfunction-correlates with the severity of injury and outcome.

Discussion: Our findings support previous literature on the role of metabolic dysfunction after TBI.

Methods: Using a recently developed magnetic resonance (MR) technique for the measurement of oxygen saturation, we determined the whole-brain OEF in both pediatric TBI patients and in healthy controls. Injury and outcome were classified using pediatric versions of the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale-Extended (GOS-E), respectively.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Analysis of Variance
  • Brain / metabolism*
  • Brain / pathology
  • Brain Injuries / diagnosis
  • Brain Injuries / metabolism*
  • Brain Injuries / pathology
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Diffusion Magnetic Resonance Imaging
  • Down-Regulation
  • Glasgow Coma Scale
  • Humans
  • Missouri
  • Oximetry
  • Oxygen / metabolism*
  • Oxygen Consumption*
  • Predictive Value of Tests
  • Prognosis
  • Severity of Illness Index
  • Time Factors

Substances

  • Oxygen