Brain Blood Flow and Cerebral Autoregulation Monitoring in Critically Ill Children

Summary

This study uses a non-invasive (external) ultrasound test called Transcranial Doppler (TCD) to measure how blood flows through the major arteries of the brain of children receiving care in the Pediatric Intensive Care Unit (PICU). TCD is already used for clinical reasons in many children, but it is not part of routine monitoring for every critically ill child. By using TCD, the investigators hope to better understand how brain blood flow changes during illness. They will also track children's functional status from before their illness to the time of PICU discharge to explore how brain blood flow patterns relate to neurological outcomes.125 participants will be enrolled and will be on study while in the PICU, estimated to be 3-14 days.

Detailed Description

Current clinical management of hemodynamics in critically ill children relies primarily on systemic parameters (e.g., blood pressure, heart rate) rather than direct assessment of cerebrovascular regulation. This approach may overlook individual variations in cerebral autoregulation (CA) capacity, potentially leading to suboptimal cerebral perfusion. By prospectively evaluating TCD-derived CA indices in intubated pediatric patients with arterial blood pressure monitoring, this study aims to: 1. Establish normative Cerebral blood flow velocity (CBFV) ranges for critically ill children 2. Describe CBFV patterns across critically ill pediatric populations with varying neurologic risk profiles 3. Characterize the prevalence of CA dysfunction in a heterogeneous PICU population 4. Explore associations between CA/CBFV and functional outcomes These data could: 1. Provide age-stratified CBFV reference values for the PICU setting 2. Identify patients at highest risk of neurological morbidity using population-specific thresholds 3. Inform future trials of autoregulation-guided hemodynamic management

Eligibility Criteria

Interventions