{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:55:18Z","timestamp":1760151318083,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017654","name":"Phoenix Children's Hospital","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100017654","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: We investigated how changes in partial pressure of brain tissue oxygenation (PbtO2) relate to end-tidal carbon dioxide (EtCO2) after pediatric traumatic brain injury (TBI). Methods: Dynamic structural equation modeling (DSEM) was used to investigate associations between EtCO2 and PbtO2, with positive associations indicating intact CO2 reactivity of PbtO2, and negative associations indicating impaired reactivity. Sub-analyses were performed to investigate associations of PbtO2 to intracranial pressure (ICP), arterial blood pressure (ABP) and cerebral regional oximetry (rSO2). Results: Among 14 patients, a positive association between PbtO2 and EtCO2 was demonstrated (SRC 0.05, 95% CI [0.04, 0.06]), with 9 patients demonstrating intact CO2 reactivity and 5 patients demonstrating impaired reactivity. Patients demonstrating intact CO2 reactivity had positive associations between PbtO2 and ICP (0.22 [0.21, 0.23]), whereas patients with impaired reactivity had negative associations (\u22120.28 [\u22120.29, \u22120.28]). Patients demonstrating intact CO2 reactivity had negative associations between PbtO2 and rSO2 (\u22120.08 [\u22120.09, \u22120.08]), whereas patients with impaired reactivity had positive associations (\u22120.15 [0.14, 0.16]). Compared to patients with intact CO2 reactivity, those with impaired reactivity had increased ICP (p &lt; 0.0000), lower PbtO2 (p &lt; 0.0000) and higher PRx (p = 0.0134). Conclusion: After TBI, CO2 reactivity of PbtO2 can be heterogenous, necessitating further work investigating factors contributing toward impaired reactivity.<\/jats:p>","DOI":"10.3390\/children9030409","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T03:06:10Z","timestamp":1647313570000},"page":"409","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Carbon Dioxide Reactivity of Brain Tissue Oxygenation after Pediatric Traumatic Brain Injury"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3278-5394","authenticated-orcid":false,"given":"Damla","family":"Hanalioglu","sequence":"first","affiliation":[{"name":"Barrow Neurological Institute at Phoenix Children\u2019s Hospital, Phoenix, AZ 85016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Colorado School of Medicine, Aurora, CO 80045, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u2019Hamed","family":"Temkit","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute at Phoenix Children\u2019s Hospital, Phoenix, AZ 85016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. David","family":"Adelson","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute at Phoenix Children\u2019s Hospital, Phoenix, AZ 85016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5396-2559","authenticated-orcid":false,"given":"Brian","family":"Appavu","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute at Phoenix Children\u2019s Hospital, Phoenix, AZ 85016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/S0020-1383(02)00193-6","article-title":"Prevalence of traumatic brain injury amongst children admitted to hospital in one health district: A population based study","volume":"354","author":"Hawley","year":"2003","journal-title":"Injury"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S1474-4422(17)30371-X","article-title":"Traumatic brain injury: Integrated approaches to improve prevention, clinical care, and research","volume":"16","author":"Maas","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/PCC.0000000000001735","article-title":"Guidelines for the management of pediatric severe traumatic brain injury, third edition: Update of the brain trauma foundation guidelines","volume":"20","author":"Kochanek","year":"2019","journal-title":"Pediatr. 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