BACKGROUND: Transcranial Doppler (TCD) sonography of major cerebral arteries is now recommended for routine screening for stroke risk in children with sickle cell disease (SCD). METHODS: We performed TCD studies on children with sickle cell anemia (SCA) seen at the pediatric hematology clinic over a period of 2 years. TCD scans were repeated yearly in children with normal flow velocities and every 3 months in children with elevated velocities. Findings were correlated with clinical variables, hematologic indices, and arterial oxygen saturation. Predictors of elevated velocities were identified by multiple linear regressions. RESULTS: We enrolled 237 children and performed a total of 526 TCD examinations. Highest time-averaged maximum flow velocities were ≥170 cm/s in 72 (30.3%) cases and ≥200 cm/s in 20 (8.4%). Young age, low hematocrit, low hemoglobin, and arterial oxygen desaturation <95% showed significant correlations with presence of increased cerebral flow velocities. CONCLUSIONS: Low hematocrit, low hemoglobin concentration, young age, and low arterial oxygen desaturation predicted elevated cerebral blood flow velocities and, invariably, increased stroke risk, in children with SCA. Children who exhibit these features should be given high priority for TCD examination in the setting of limited resources.
BACKGROUND: Transcranial Doppler (TCD) sonography of major cerebral arteries is now recommended for routine screening for stroke risk in children with sickle cell disease (SCD). METHODS: We performed TCD studies on children with sickle cell anemia (SCA) seen at the pediatric hematology clinic over a period of 2 years. TCD scans were repeated yearly in children with normal flow velocities and every 3 months in children with elevated velocities. Findings were correlated with clinical variables, hematologic indices, and arterial oxygen saturation. Predictors of elevated velocities were identified by multiple linear regressions. RESULTS: We enrolled 237 children and performed a total of 526 TCD examinations. Highest time-averaged maximum flow velocities were ≥170 cm/s in 72 (30.3%) cases and ≥200 cm/s in 20 (8.4%). Young age, low hematocrit, low hemoglobin, and arterial oxygen desaturation <95% showed significant correlations with presence of increased cerebral flow velocities. CONCLUSIONS:Low hematocrit, low hemoglobin concentration, young age, and low arterial oxygen desaturation predicted elevated cerebral blood flow velocities and, invariably, increased stroke risk, in children with SCA. Children who exhibit these features should be given high priority for TCD examination in the setting of limited resources.
Authors: Neelum D Jeste; Luisanna M Sánchez; Gabriela S Urcuyo; Melissa E Bergés; Judy P Luden; Susan E Stuber; Teresa S Latham; Rafael Mena; Rosa M Nieves; Russell E Ware Journal: JMIR Res Protoc Date: 2017-06-02
Authors: André L N Gobatto; Milena A Link; Davi J Solla; Estevão Bassi; Paulo F Tierno; Wellingson Paiva; Fabio S Taccone; Luiz M Malbouisson Journal: Crit Care Date: 2019-03-12 Impact factor: 9.097
Authors: Sylvia Thurn; Katharina Kleinschmidt; Irena Kovacic; Christina Wendl; Ralf A Linker; Selim Corbacioglu; Felix Schlachetzki Journal: Neurol Res Pract Date: 2022-04-04