Objective: The objective of this study was to describe changes in cerebral autoregulation after severe pediatric traumatic brain injury (TBI).
Materials and methods: Two cerebral autoregulation tests were performed during the first 10 days after severe TBI in children <16 years. Cerebral autoregulation was quantified using the mean autoregulatory index (mARI).
Results: Nine (five males/four females) children (10 +/- 5 years) with severe (admission Glasgow Coma Scale (GCS), 5 +/- 2) TBI were enrolled. Thirty (3/9) percent of initial exams revealed impaired cerebral autoregulation; all three had returned to intact cerebral autoregulation on second exam. However, in three of nine (33%) patients, cerebral autoregulation worsened on second exam. Of the factors examined, worsening mARI on second exam was associated with worsening head computed tomography (CT) lesion.
Conclusions: Cerebral autoregulation often changed and worsened during the first 9 days after severe pediatric TBI. Worsening cerebral autoregulation may mirror worsening TBI.