This study examines cerebral oxygen saturation (ScO2) in children with meningitis. Ischemia, secondary to vascular thromboses and intracranial hypertension, plays a major role in the pathophysiology of brain injury. We hypothesize that ScO2 is decreased in children with meningitis, reflecting an increased oxygen extraction from tissue ischemia. Near infrared spectroscopy (NIRS) is a non-invasive optical technique that monitors ScO2 at the bedside by measuring a mixed vascular saturation within arterioles, venules, and capillaries. Using this new technology, we are measuring ScO2 in children admitted to the pediatric and neonatal intensive care units with the diagnosis of meningitis. Serial measurements are made over time, beginning with admission and at 12 hour intervals thereafter. To date, we have studied 11 children with ages ranging between 3 weeks and 7 years. Preliminary data demonstrates that these children do have lower ScO2 values compared with a control group. In addition, a subgroup of children with meningitis in whom cerebral infarction developed demonstrated lower ScO2 values over time than the meningitis patients who had no infarction. We will to continue enrollment until our target number of 15 patients is reached, after which we will publish this data as a case series. Based on these findings, we will develop future multicenter studies so that NIRS may rigorously be evaluated as a tool in the diagnosis and treatment of cerebral ischemia in children with meningitis.
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