Pediatric Severe Traumatic Brain Injury

Pediatric Severe Traumatic Brain Injury

see Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition.

New level II and level III evidence-based recommendations and an algorithm provide additional guidance for the development of local protocols to treat pediatric patients with severe traumatic brain injury. The intention is to identify and institute a sustainable process to update these Guidelines as new evidence becomes available 1).

Greenan et al., used database research to evaluate admission clinical and CT scan characteristics for use as a decision tool to help clinicians caring for children with very severe traumatic brain injury. It may help clinicians identify children who can benefit the most from aggressive medical and surgical intervention 2).


Sarnaik et al., failed to detect mortality differences across age strata in children with severe TBI. We have discerned novel associations between age and various markers of injury-unrelated to AHT-that may lead to testable hypotheses in the future 3).

References

1)

Kochanek PM, Tasker RC, Carney N, Totten AM, Adelson PD, Selden NR, Davis-O’Reilly C, Hart EL, Bell MJ, Bratton SL, Grant GA, Kissoon N, Reuter-Rice KE, Vavilala MS, Wainwright MS. Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition: Update of the Brain Trauma Foundation Guidelines, Executive Summary. Pediatr Crit Care Med. 2019 Mar;20(3):280-289. doi: 10.1097/PCC.0000000000001736. PubMed PMID: 30830016.
2)

Greenan K, Taylor SL, Fulkerson D, Shahlaie K, Gerndt C, Krueger EM, Zwienenberg M. Selection of children with ultra-severe traumatic brain injury for neurosurgical intervention. J Neurosurg Pediatr. 2019 Apr 5:1-10. doi: 10.3171/2019.1.PEDS18293. [Epub ahead of print] PubMed PMID: 30952132.
3)

Sarnaik A, Ferguson NM, O’Meara AMI, Agrawal S, Deep A, Buttram S, Bell MJ, Wisniewski SR, Luther JF, Hartman AL, Vavilala MS; Investigators of the ADAPT Trial. Age and Mortality in Pediatric Severe Traumatic Brain Injury: Results from an International Study. Neurocrit Care. 2018 Jun;28(3):302-313. doi: 10.1007/s12028-017-0480-x. PubMed PMID: 29476389.

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