Table 4.
Demographics, laboratory investigations, imaging, and outcomes by Transcranial Doppler Ultrasound phenotype
| Variable | Hyperemia (n = 57) |
IPH (n = 35) |
Low flow (n = 50) |
MO (n = 14) |
Vasospasm (n = 11) |
Normal (n = 7) |
p |
|---|---|---|---|---|---|---|---|
| Age (months), mean (SD) | 55 (31) | 58 (37) | 59 (37) | 56 (25) | 67 (32) | 72 (29) | 0.71 |
| Temperature (°C), median [IQR] |
38.5 [37.7, 39.1] |
38.5 [37.8, 39.4] |
38.0 [37.1, 39.2] |
38.5 [37.6, 39.3] |
37.8 [37.6, 38.5] |
38.5 [38.0, 39.0] |
0.25 |
| Heart rate (beats/min), median [IQR] |
141 [127, 152] |
143 [128, 158] |
142 [123, 161] |
140 [124, 158] |
140 [136, 146] |
133 [130, 136] |
0.97 |
| RR (breaths/min), median [IQR] |
32.0 [26.0, 39.0] |
36.0 [28.0, 43.0] |
36.0 [32.0, 42.8] |
34.5 [32.2, 39.5] |
36.0 [32.5, 44.5] |
40.0 [39.5, 45.0] |
0.07 |
| Oxygen saturation (%), median [IQR] |
97.0 [95.0, 98.0] |
97.0 [96.0, 99.0] |
97.0 [95.0, 98.0] |
98.0 [96.2, 98.0] |
98.0 [97.0, 99.0] |
96.0 [96.0, 97.5] |
0.21 |
| MBP (mmHg), median [IQR] |
78.0 [71.0, 84.0] |
78.0 [72.5, 86.5] |
83.5 [73.2, 90.0] |
73.0 [65.8, 80.5] |
75.0 [68.5, 86.5] |
74.0 [71.0, 79.0] |
0.21 |
| Pulse pressure (mmHg), median [IQR] |
43.0 [39.0, 55.0] |
38.0 [35.0, 44.0] |
37.5 [33.0, 44.8] |
35.5 [34.0, 43.2] |
38.0 [35.0, 42.0] |
33.0 [33.0, 35.5] |
0.003 |
| Stroke volume index (ml/m2), median [IQR] |
39.0 [34.2, 44.8] |
39.0 [33.5, 43.5] |
32.0 [28.5, 41.0] |
43.0 [38.2, 50.8] |
42.0 [38.2, 46.2] |
38.0 [35.0, 42.5] |
0.08 |
| Cardiac index (l/min/m2), median [IQR] |
5.30 [4.90, 5.88] |
5.40 [4.55, 5.90] |
4.40 [3.70, 5.00] |
6.00 [5.18, 6.60] |
5.55 [5.20, 6.60] |
4.20 [4.00, 5.05] |
< 0.001 |
| SVRI (d.s.cm−5m2), median [IQR] | 1270 [1070, 1392] | 1306 [1198, 1580] |
1552 [1197, 1961] |
962 [919, 991] |
1187 [903, 1334] |
1378 [1294, 1660] |
0.003 |
| Packed Cell Volume (%),median [IQR] |
26.0 [20.0, 29.0] |
26.0 [21.5, 30.0] |
27.5 [22.2, 32.8] |
27.5 [24.2, 30.8] |
23.0 [19.5, 25.0] |
27.0 [25.0, 28.0] |
0.08 |
| Glucose (mmol/L), median [IQR] |
5.30 [4.40, 6.20] |
5.90 [4.60, 6.60] |
5.65 [4.40, 6.90] |
5.30 [4.38, 8.85] |
5.80 [5.40, 6.60] |
5.70 [5.15, 6.50] |
0.74 |
| Lactate (mmol/L), median [IQR] |
4.30 [2.60, 6.80] |
3.00 [2.10, 5.30] |
4.05 [2.02, 8.60] |
4.15 [2.10, 6.95] |
5.00 [2.75, 8.35] |
4.00 [3.00, 4.70] |
0.87 |
| Parasites/microliter blood, median [IQR] |
455,000 [27,000, 975,000] |
346,000 [108,000, 1,499,000] |
464,000 [180,000 1,280,000] |
126,000 [67,000, 459,000] |
116,000 [62,000, 237,000] |
246,000 [174,000, 815,000] |
0.52 |
| PfHRP2 (ng/mL), median [IQR] |
396 [111,1021] |
913 [46, 1270] |
333 [122, 874] |
123 [13, 282] |
330 [44,687] |
807 [545, 996] | .006 |
| pH, median [IQR] |
7.42 [7.36, 7.46] |
7.42 [7.36, 7.45] |
7.41 [7.38, 7.46] |
7.44 [7.36, 7.48] |
7.38 [7.35, 7.50] |
7.41 [7.38, 7.44] |
0.99 |
| CO2 (mmHg), median [IQR] |
29.0 [23.0, 36.0] |
28.5 [24.8, 34.0] |
27.5 [24.0, 31.0] |
27.0 [24.5, 30.5] |
22.5 [18.0, 26.5] |
26.0 [25.5, 34.5] |
0.53 |
| Base excess, median [IQR] |
2.10 [-3.00, 6.50] |
0.80 [-6.50, 6.00] |
0.10 [-6.00, 5.00] |
3.30 [2.70, 7.82] |
3.00 [0.50, 20.2] |
5.00 [1.50, 6.00] |
0.22 |
| Sodium (mEq/L), median [IQR] |
139 [137, 143] |
139 [136, 144] |
140 [135, 143] |
136 [134, 139] |
138 [134, 140] |
141 [137, 146] |
0.29 |
| Bicarbonate (mmol/L), median [IQR] |
17.0 [13.0, 20.2] |
17.0 [15.0, 19.0] |
18.0 [13.5, 20.5] |
17.8 [12.2, 20.0] |
18.0 [13.5, 21.5] |
18.5 [17.8, 20.0] |
0.93 |
| Retinopathy positive, n (%) | 37 (65) | 21 (60) | 36 (72) | 10 (71.4) | 6 (54.5) | 5 (71.4) | 0.80 |
| Blantyre coma score, n (%) | 0.05 | ||||||
| 0 | 7 (13) | 5 (14) | 8 (16) | 4 (29) | 2 (18) | 0 (0) | |
| 1 | 15 (26) | 14 (40) | 26 (52) | 3 (21) | 3 (27) | 3 (43) | |
| 2 | 35 (61) | 16 (46) | 16 (32) | 7 (50) | 6 (55) | 4 (57) | |
| Seizures on EEG, n (%) | 6 (11) | 1 (3) | 4 (8) | 3 (21) | 2 (18) | 0 (0) | 0.38 |
| Papilloedema present, n (%) | 3 (5) | 1 (3) | 3 (6) | 2 (14) | 1 (9) | 0 (0) | 0.37 |
| Opening pressure (cm H20), median [IQR] |
15.5 [12.0, 21.5] |
16.0 [13.5, 21.5] |
17.0 [12.0, 22.0] |
18.0 [14.0, 19.0] |
21.5 [12.8, 26.0] |
19.0 [12.0, 23.5] |
0.83 |
| ONSD (mm), median [IQR] |
0.48 [0.44, 0.53] |
0.48 [0.44, 0.50] |
0.48 [0.45, 0.50] |
0.49 [0.45, 0.53] |
0.45 [0.42, 0.48] |
0.46 [0.44, 0.47] |
0.59 |
| Time to coma resolution (hrs), median [IQR] |
26.0 [20.0, 61.5] |
44.0 [24.0, 79.5] |
52.0 [25.5, 90.5] |
40.0 [31.0, 51.0] |
47.0 [19.5, 114] |
36.0 [27.0, 36.0] |
0.23 |
| Brain volume score, n (%)* | n = 34 | n = 17 | n = 24 | n = 10 | n = 7 | n = 2 | 0.95 |
| 3 | 3 (9) | 1 (6) | 1 (4) | 1 (10) | 1 (14) | 0 (0) | |
| 4 | 3 (9) | 1 (6) | 3 (13) | 1 (10) | 0 (0) | 0 (0) | |
| 5 | 13 (38) | 6 (35) | 8 (33) | 3 (30) | 3 (43) | 0 (0) | |
| 6 | 9 (26) | 4 (24) | 5 (21) | 2 (20) | 2 (29) | 2 (100) | |
| 7 | 5 (15) | 5 (29) | 5 (21) | 2 (20) | 1 (14) | 0 (0) | |
| 8 | 1 (3) | 0 (0) | 2 (8) | 1 (10) | 0 (0) | 0 (0) | |
| Autoregulation (THRR), median [IQR] |
1.05 [1.01, 1.12] |
1.11 [1.07, 1.19] |
1.10 [1.03, 1.20] |
1.09 [1.07, 1.13] |
1.04 [1.01, 1.06] |
1.20 [1.14;1.27] | 0.13 |
| Outcome, n (%) | < .001 | ||||||
| Good | |||||||
| PCPC 1 -2 (normal, mild disability) | 44 (77) | 31 (89) | 21 (42) | 9 (64) | 6 (55) | 7 (100) | |
| Poor | |||||||
| PCPC 3–5 (moderate to severe disability) | 8 (14) | 3(9) | 14 (28) | 3 (21) | 5 (45) | 0 (0) | |
| PCPC 6 (died) | 5 (9) | 1 (2) | 15 (30) | 2 (15) | 0 (0) | 0 (0) |
n number, SD standard deviations, hrs hours, RR respiratory rate, SBP systolic blood pressure, mmHg millimeters mercury, DBP diastolic blood pressure; MBP mean blood pressure, IQR interquartile range, SVRI systemic vascular resistive index, PfHRP2 Plasmodium falciparum histidine rich protein 2, CO2 carbon dioxide, NIRS near-infrared spectroscopy, SO2 cerebral oxygen saturation, EEG electroencephalogram, OP opening pressure, ONSD optic nerve sheath diameter, THRR transient hyperemic response ratio, MRI magnetic resonance imaging, TCD transcranial doppler ultrasound, CSF cerebrospinal fluid
MRI data are available for 94 participants