Assessment of Cerebral Perfusion Pressure by Transcranial Doppler in Pediatric Patients with Convulsive Status Epilepticus.

IF 1.5 4区医学 Q2 PEDIATRICS Indian pediatrics Pub Date : 2025-04-01 Epub Date: 2025-03-12 DOI:10.1007/s13312-025-00002-y

Aritra Kapat, Angana Bhattacharjee, Kaushani Chatterjee, Gobinda Mondal, Asok Kumar Mandal

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Abstract

Objective: To study the changes in cerebral hemodynamics and cerebral perfusion pressure (CPP) in children with convulsive status epilepticus (SE) by bedside transcranial doppler (TCD).

Methods: Transcranial doppler of bilateral middle cerebral artery (MCA) was performed in 42 antiepileptic drug naïve convulsive SE patients (1-12 years) within 30 min of seizure termination and in 42 hemodynamically stable patients with non-neurological symptoms without any pre-existing cardiovascular and renal pathologies. The mean flow velocity (Fvm), diastolic flow velocity (Fvd) and peak systolic velocity (PSV) were measured, and CPP was calculated.

Results: Mean (SD) Fvd, PSV, Fvm, and CPP in the right MCA in study group was 57.85 (3.57) cm/s, 139.90 (7.07) cm/s 85.19 (3.30) cm/s and 68.40 (4.91) mm Hg, respectively, and corresponding values in left MCA were 58.04 (3.35) cm/s, 139.90 (6.96) cm/s, 85.30 (3.20) cm/s, and 68.50 (4.93) mmHg. Alterations of Fvd, PSV, and Fvm and CPP were statistically significant in the study group compared to comparator group.

Conclusion: Bedside TCD within 30 min of seizure termination in SE patients can detect alterations in cerebral flow velocities risking cerebral hypoperfusion.

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经颅多普勒评价小儿惊厥性癫痫持续状态的脑灌注压。

目的：应用床边经颅多普勒（TCD）研究惊厥性癫痫持续状态（SE）患儿脑血流动力学和脑灌注压（CPP）的变化。方法：对42例（1-12岁）抗癫痫药物naïve惊厥性SE患者和42例血流动力学稳定且无心血管和肾脏病变的非神经系统症状患者，在癫痫发作结束后30分钟内行双侧大脑中动脉（MCA）经颅多普勒检查。测量平均血流速度（Fvm）、舒张血流速度（Fvd）和峰值收缩速度（PSV），计算CPP。结果：研究组右侧中动脉Fvd、PSV、Fvm、CPP均值（SD）分别为57.85 (3.57)cm/s、139.90 (7.07)cm/s、85.19 (3.30)cm/s、68.40 (4.91)mmHg，左侧中动脉Fvd、PSV、Fvm、CPP均值（SD）分别为58.04 (3.35)cm/s、139.90 (6.96)cm/s、85.30 (3.20)cm/s、68.50 (4.93)mmHg。与对照组相比，研究组Fvd、PSV、Fvm、CPP的变化均有统计学意义。结论：SE患者癫痫发作结束后30 min内床边TCD可检测脑血流速度的变化，有脑灌注不足的危险。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.