Cerebral Oximetry for the Assessment of Pediatric Head Injuries – a Prospective Trial
2Department of Pediatric Emergency Medicine, Hadassah-Hebrew University Medical Center, Jerusalem
3Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem
4Department of General Surgery, Hadassah-Hebrew University Medical Center, Jerusalem
Background: Pediatric traumatic head injury is a common referral cause to the pediatric emergency department, while most injuries are minor it is essential to timely diagnosed those who will need immediate imaging and neurosurgical intervention. Few studies have assessed the use of cerebral oximetry technology in children.
Objective: To assess the sensitivity and specificity of the Infrascanner © hand held brain injury detection device in identifying intracranial bleeding in children.
Methods: A prospective study was conducted in a tertiary, level I trauma center during 2020-2021. Children presented to the PED with head injuries and required head CT during their assessment were enrolled. Brain oximetry scans were compared to their head CT and clinical findings.
Results:58 children were enrolled. In the sample, 40/55 (72.7%) were male. The average age was 6.54 ± 5.32 years. Fifteen (27.3%) were hospitalized, no cases of mortality were documented. Twelve (22.6%) had extra-cranial parietal hematomas, three patients (5.5%) had findings consistent with skull fractures, and three patients (5.5%) had hemotympanum or other signs consistent with a base of skull fracture.
Twenty-one (38.1%) were identified as having abnormal findings on the CT scan. Ten suffered from ciTBI. The sensitivity and specificity of the abnormal Infrascanner findings in comparison to fracture and bleeding as identified by CT scan was 90% and 76% respectively, with an area under the curve of 0.821 (95% CI [0.65-0.95]), a NPV of 75% and a PPV of 85%.
Conclusion: The Infrascanner device has a high negative predictive value for intracranial bleeding in children.