Document Detail


Effect of altitude on cerebral oxygenation during pediatric interfacility transport.
MedLine Citation:
PMID:  22453725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The objectives of this study were to determine the usefulness of cerebral oxygenation monitoring during interfacility helicopter transport of pediatric patients and to determine the effect of changes in altitude during transport on cerebral oxygenation readings in pediatric interfacility transport patients.
METHODS: A convenience sample of pediatric interfacility helicopter transport patients were monitored using near-infrared spectroscopy (NIRS) technology. Cerebral oxygenation numbers were collected at baseline and at cruising altitude in patients on room air, supplemental oxygen, and mechanical ventilation. Comparisons among readings were performed to determine the effect of changing altitude during helicopter transport on cerebral oxygenation.
RESULTS: Seventeen pediatric patients were monitored at various altitudes during interfacility helicopter transport. When compared collectively, there was no difference in NIRS readings at baseline (B) and at altitude (A): B--65.9% (SD, 9.5%) versus A--65.0% (SD, 9.9%) (P = 0.06). In patients transported at greater than 5000 ft above ground level, there was a statistically significant difference in NIRS readings: B--69.2% (SD, 8.9%) versus A--66.3% (SD, 9.8%) (P < 0.001). Patients requiring mechanical ventilator support also had statistically significant differences in NIRS readings above 5000 ft above ground level: B--78.1% (SD, 5.9%) versus A--75.0% (SD, 3.5%) (P = 0.01).
CONCLUSIONS: Cerebral oxygenation monitoring, using NIRS technology, can be used as a monitoring tool during pediatric helicopter transport. Cerebral oxygenation may change with acute changes in altitude, especially in pediatric patients requiring high levels of respiratory support. This technology has the potential to be used to monitor tissue oxygenation and possibly guide therapeutic interventions during pediatric transport.
Authors:
Michael H Stroud; Punkaj Gupta; Parthak Prodhan
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric emergency care     Volume:  28     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-06     Completed Date:  2012-08-14     Revised Date:  2012-09-13    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  329-32     Citation Subset:  IM    
Affiliation:
Section of Pediatric Critical Care Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, AR, USA. StroudMichaelH@uams.ed
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Air Ambulances*
Aircraft
Altitude*
Altitude Sickness / etiology,  metabolism,  prevention & control
Brain / metabolism*
Cerebrovascular Circulation
Child
Child, Preschool
Emergencies*
Female
Follow-Up Studies
Humans
Infant
Male
Monitoring, Physiologic / methods
Oxygen / metabolism*
Oxygen Consumption / physiology*
Retrospective Studies
Spectroscopy, Near-Infrared / methods
Transportation of Patients / methods*
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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