000 03446cam a2200349 a 4500
003 EG-GiCUC
005 20250223031937.0
008 180303s2017 ua dh f m 000 0 eng d
040 _aEG-GiCUC
_beng
_cEG-GiCUC
041 0 _aeng
049 _aDeposite
097 _aPh.D
099 _aCai01.11.28.Ph.D.2017.Ah.T
100 0 _aAhmed Galal Mohamed
245 1 0 _aTranscranial doppler assessment of cerebral perfusion in patients with severe sepsis & septic shock in pediatric ICU /
_cAhmed Galal Mohamed ; Supervised Ahmed Saadeldin Elbeleidy , Seham Awad Elsherbini , Rania Hachim Hamdi
246 1 5 _aإستخدام جهاز الدوبلر علي الشرايين المخية لتقييم التغذية الدموية للمخ قي الاطفال المصابين بتسمم الدم و الصدمة البكتيرية في الرعاية المركزة
260 _aCairo :
_bAhmed Galal Mohamed ,
_c2017
300 _a122 P. :
_bcharts , facsimiles ;
_c25cm
502 _aThesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics
520 _aBackground:Sepsis-associated encephalopathy (SAE) is one of the most common causes of delirium in intensive care units. Its pathophysiology is complex and related to numerous processes and pathways.Alterations of the cerebral blood flow (CBF) may represent a key component for the development of SAE which may be caused by cerebral vasoconstriction. Transcranial Doppler (TCD) allows real-time accurate detection of CBF. Objectives:to assess changes in cerebral hemodynamic characteristics in pediatric septic encephalopathy patients Methodology: a prospective case control study including 75 critically ill children; 45 patients were diagnosed as severe sepsis or septic shock with encephalopathy, while the other 30 critically ill patients who were neither septic nor encephalopathic served as control.Patients were examined using the TCD on the middle cerebral artery.Pulsatility (PI) and resistive (RI) indices were measured to assess the cerebrovascular resistance (CVR). Results:cerebrovascular resistance (CVR) was higher in the septic group. This is evidenced by significantly higher PI and RI in the septic encephalopathic group than controlone (P<0.01). CO2 reactivity was impaired as there was positive statistically significant correlation between both PI and RI, and PaCO2 (r=0.4, P<0.01 and r=0.374, P=0.01 respectively). The level of consciousness of the patients was assessed by FOUR score; PI was negatively correlated to FOUR score with high significance (r = -0.357, and P=0.016). This means that pulsatility index increased with the more deepening of coma. PI and RI were significantly higher in the non-survivor cases than the survivor ones (P<0.01). By using a regression analysis method; PI was an independent risk of mortality with (O.R= 257, 95%CI= 6.1-108, P<0.01) Conclusion:in pediatric patients with SAE; CVR is higher with decreased cerebral blood flow and CO2 reactivity is impaired
530 _aIssued also as CD
653 4 _aPulsatility index
653 4 _aSepsis associated encephalopathy
653 4 _aTranscranial Doppler
700 0 _aAhmed Saadeldin Elbeleidy ,
_eSupervisor
700 0 _aRania Hachim Hamdi ,
_eSupervisor
700 0 _aSeham Awad Elsherbini ,
_eSupervisor
856 _uhttp://172.23.153.220/th.pdf
905 _aNazla
_eRevisor
905 _aShimaa
_eCataloger
942 _2ddc
_cTH
999 _c65246
_d65246