An Increased Pulsatility Index in Transcranial Doppler Sonography Is Associated with Shiga-Toxin-Related Encephalopathy in Hemolytic Uremic Syndrome

Albers, J.M.C.; Pavenstaedt, Hermann; Dlugos, Cynthia A.; Lebiedz, Pia; Ringelstein, E. B.; Dittrich, Ralf; Ritter, Martin

doi:10.1159/000335826

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Trauma is the leading cause of paediatric mortality, potential years of life lost, and accounts for a significant medical cost in the developed world. 1,2 Paediatric trauma places a significant emotional and economic burden upon families. Prior estimates of annual costs related to paedia-tric trauma, in the United States alone, are more than $200 billion.…”

Section: Introductionmentioning

confidence: 99%

Low Plasma ADAMTS13 Activity Is Associated with Coagulopathy, Endothelial Cell Damage and Mortality after Severe Paediatric Trauma

et al. 2018

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Summary Decrease of plasma activity of ADAMTS13, a metalloenzyme that cleaves von Willebrand factor (VWF) and prevents adhesion and aggregation of platelets, has been reported early after onset of systemic inflammation resulting from infections and after severe trauma. Here, we determined whether trauma-induced systemic (sterile) inflammation would be associated with a reduction of plasma ADAMTS13 activity in pediatric patients and its association with disease severity and outcome. Pediatric patients (n=106) with severe trauma at a level 1 pediatric trauma center between 2014 and 2016 were prospectively enrolled. Blood samples were collected upon arrival and at 24 hours and analyzed for plasma levels of ADAMTS13 activity, VWF antigen, collagen binding activity, human neutrophil peptides (HNP) 1-3, coagulation abnormalities, endothelial glycocalyx damage, and clinical outcome. Plasma samples were also collected for similar measurements from 52 healthy pediatric controls patients who underwent elective minor surgery. The median patient age was 9 years with 81% sustaining blunt trauma. The median injury severity score was 22 and the mortality rate was 11%. Plasma levels of ADAMTS13 activity were significantly lower and plasma levels of VWF antigen and HNP1-3 proteins were significantly higher for pediatric trauma patients on admission and at 24 hours when compared to controls. Finally, the lowest plasma ADAMTS13 activity was found in patients who died from their injuries. We conclude that relative plasma deficiency of ADAMTS13 activity may be associated with more severe traumatic injury, significant endothelial glycocalyx damage, coagulation abnormalities and mortality after severe trauma in pediatric patients.

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Section: Introductionmentioning

confidence: 99%

Low Plasma ADAMTS13 Activity Is Associated with Coagulopathy, Endothelial Cell Damage and Mortality after Severe Paediatric Trauma

et al. 2018

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“…Furthermore, TCD is a reliable method for estimating the intracranial pressure (ICP) -particularly in the context of traumatic brain injury (6)(7)(8). The use of TCD has also been described in the management of sepsis ( 9), central nervous system (CNS) infections (10,11), and liver and kidney failure (12)(13)(14) -all conditions that are frequently managed in intensive care units (ICUs).…”

Section: Introductionmentioning

confidence: 99%

Transcranial Doppler Use in Non-traumatic Critically Ill Children: A Multicentre Descriptive Study

Rollet-Cohen

Sachs²,

Léger³

et al. 2021

Front. Pediatr.

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Background: The use and perceived value of transcranial Doppler (TCD) scope in paediatric critical care medicine has not been extensively documented.Objective: To describe the use of TCD to assess non-traumatic brain injury in patients admitted to four paediatric intensive care units (PICUs) in France.Methods: We prospectively included all children (aged under 18) assessed with inpatient TCD between November 2014 and October 2015 at one of the four PICUs. The physicians completed a questionnaire within 4 h of performing TCD.Results: 152 children were included. The primary diagnosis was neurological disease in 106 patients (70%), including post ischemic-anoxic brain insult (n = 42, 28%), status epilepticus (n = 19, 13%), and central nervous system infection/inflammation (n = 15, 10%). TCD was the first-line neuromonitoring assessment in 110 patients (72%) and was performed within 24 h of admission in 112 patients (74%). The most common indications for TCD were the routine monitoring of neurological disorders (n = 85, 56%) and the detection of asymptomatic neurological disorders (n = 37, 24). Concordance between the operator's interpretation of TCD and the published normative values was observed for 21 of the 75 (28%) TCD abnormal findings according to the published normative values. The physicians considered that TCD was of value for the ongoing clinical management of 131 (86%) of the 152 patients.Conclusion: TCD is commonly used in French PICUs and tends to be performed early after admission on patients with a broad range of diseases. The physicians reported that the TCD findings often helped their clinical decision making. In view of the subjectivity of bedside interpretation, true TCD contribution to clinical care remains to be determined. Objective studies of the impact of TCD on patient management and clinical outcomes are therefore warranted.

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Public Health Research Resulting from One of the World’s Largest Outbreaks Caused by Entero-Hemorrhagic Escherichia coli in Germany 2011: A Review

Köckerling

Karrasch

Schweitzer

et al. 2017

Front. Public Health

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In 2011, Germany experienced one of the largest outbreaks of entero-hemorrhagic Escherichia coli (EHEC) ever reported. Four years thereafter, we systematically searched for scientific publications in PubMed and MEDPILOT relating to this outbreak in order to assess the pattern of respective research activities and to assess the main findings and recommendations in the field of public health. Following PRISMA guidelines, we selected 133 publications, half of which were published within 17 months after outbreak onset. Clinical medicine was covered by 71, microbiology by 60, epidemiology by 46, outbreak reporting by 11, and food safety by 9 papers. Those on the last three topics drew conclusions on methods in surveillance, diagnosis, and outbreak investigation, on resources in public health, as well as on inter-agency collaboration, and public communication. Although the outbreak primarily affected Germany, most publications were conducted by multinational cooperations. Our findings document how soon and in which fields research was conducted with respect to this outbreak.

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An Increased Pulsatility Index in Transcranial Doppler Sonography Is Associated with Shiga-Toxin-Related Encephalopathy in Hemolytic Uremic Syndrome

Cited by 3 publications

References 8 publications

Low Plasma ADAMTS13 Activity Is Associated with Coagulopathy, Endothelial Cell Damage and Mortality after Severe Paediatric Trauma

Low Plasma ADAMTS13 Activity Is Associated with Coagulopathy, Endothelial Cell Damage and Mortality after Severe Paediatric Trauma

Transcranial Doppler Use in Non-traumatic Critically Ill Children: A Multicentre Descriptive Study

Public Health Research Resulting from One of the World’s Largest Outbreaks Caused by Entero-Hemorrhagic Escherichia coli in Germany 2011: A Review

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