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Pediatr Res. 2012 Feb;71(2):199-204. doi: 10.1038/pr.2011.31. Epub 2011 Dec 21.

Depression of whole-brain oxygen extraction fraction is associated with poor outcome in pediatric traumatic brain injury.

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  • 1Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA.



Traumatic brain injury (TBI) is a leading cause of death and disability in children. Metabolic failure is an integral component of the pathological aftermath of TBI. The oxygen extraction fraction (OEF) is a valuable parameter for characterization and description of metabolic abnormalities; however, OEF measurement has required either invasive procedures or the use of ionizing radiation, which significantly limits its use in pediatric research.


Patients with TBI had depressed OEF levels that correlated with the severity of injury. In addition, the OEF measured within 2 weeks of injury was predictive of patient outcome at 3 mo after injury. In pediatric TBI patients, low OEF-a marker of metabolic dysfunction-correlates with the severity of injury and outcome.


Our findings support previous literature on the role of metabolic dysfunction after TBI.


Using a recently developed magnetic resonance (MR) technique for the measurement of oxygen saturation, we determined the whole-brain OEF in both pediatric TBI patients and in healthy controls. Injury and outcome were classified using pediatric versions of the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale-Extended (GOS-E), respectively.

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