Predictors of outcome in severely head-injured children

White, Jeanette R. M.; Farukhi, Zareen; Bull, Catherine; Christensen, James R.; Gordon, Toby A.; Paidas, Charles N.; Nichols, David G.

doi:10.1097/00003246-200103000-00011

Cited by 171 publications

(121 citation statements)

References 24 publications

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“…Large prospective randomized clinical trails are essential to compare the efficacy of different strategies [32,37,38,39,40]. These are not easy to perform in children with severe TBI since the number of children treated at each center is low.…”

Section: Discussionmentioning

confidence: 99%

Severe traumatic brain injury in pediatric patients: treatment and outcome using an intracranial pressure targeted therapy—the Lund concept

et al. 2005

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Objective: This study evaluated the outcome of treatment according to the Lund concept in children with severe traumatic brain injury and investigated whether the preset goals of the protocol were achieved. Design and setting: A twocenter retrospective study in neurointensive care units at university hospitals. Patients: Forty-one children with severe traumatic brain injury from blunt trauma and arriving at hospital within 24 h after injury. Median age was 8.8 years (range 3 months-14.2 years), Glasgow Coma Scale 7 (3-8), and Injury Severity Score 25 (16-75). All children had pathological findings on initial computed tomography. All developed intracranial hypertension, and survivors required intensive care longer than 72 h. Interventions: Treatment according to the principles of the Lund concept. Measurements and results: Neurosurgery was required in 46% of the children. Survival rate was 93% and favorable outcome (Glasgow Outcome Score 4 or 5) was 80% at long-term follow-up (median 12 months postinjury, range 2.5-26). The preset physiological and biochemical goals were achieved in over 90% of observations. Conclusions: Treating pediatric patients with severe traumatic brain injury, according to the Lund concept, results in a favorable outcome when the protocol is followed.

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Section: Discussionmentioning

confidence: 99%

Severe traumatic brain injury in pediatric patients: treatment and outcome using an intracranial pressure targeted therapy—the Lund concept

et al. 2005

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“…Three phases of change in CBF following TBI have been documented [80]: in the first 6-12 hours after injury, the brain may suffer poor perfusion and cerebral ischemia. A second phase of hyperemia often follows which is notable for "luxury perfusion" and increased intracranial pressure (ICP).…”

Section: Cerebrovascular Physiology After Tbi Altered Cerebral Blood mentioning

confidence: 99%

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Udomphorn

Armstead

Vavilala

2008

Pediatric Neurology

133

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Traumatic brain injury is a global health concern and is the leading cause of traumatic morbidity and mortality in children. Despite a lower overall mortality than in adult traumatic brain injury, the cost to society from the sequelae of pediatric traumatic brain injury is very high. Predictors of poor outcome after traumatic brain injury include altered systemic and cerebral physiology, including altered cerebral hemodynamics. Cerebral autoregulation is often impaired following traumatic brain injury and may adversely impact poor outcome. Although altered cerebrovascular hemodynamics early after traumatic brain injury may contribute to disability in children, there is a paucity of information regarding changes in cerebral blood flow and cerebral autoregulation after pediatric traumatic brain injury. In this article, we discuss normal pediatric cerebral physiology and cerebrovascular pathophysiology following pediatric traumatic brain injury.

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“…2,4,7 Tais estudos incluem redução nos índices de mortalidade por doenças específicas, 9,16,17 alterações no tempo de permanência e mortalidade 9,11,14 e em outras características das unidades de tratamento intensivo (UTI). As diferentes UTI pediátricas (UTIP) possuem características próprias, com índices de mortalidade distintos e com amplas variações (3-30%).…”

Section: Introductionunclassified

Perfil epidemiológico de dezesseis anos de uma unidade de terapia intensiva pediátrica

et al. 2002

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Descritores ResumoObjetivo Revisar e descrever os dados epidemiológicos dos pacientes admitidos em uma unidade de terapia pediátrica brasileira (UTIP) e compará-los aos aspectos clínicos associados aos índices de gravidade e mortalidade. Descrever as características desses pacientes, incluindo os dados demográficos, prevalência de doenças, índices de mortalidade e fatores associados. Métodos Os dados foram coletados retrospectivamente de todos os pacientes admitidos na UTIP de um hospital universitário entre 1978 e 1994. Os dados foram expressos em percentagens e comparados pelo teste qui-quadrado, calculando-se o risco relativo (RR) com um intervalo de confiança de 95%, considerando-se um p<0,05. Resultados Foram selecionados 13.101 pacientes -em sua maioria meninos (58,4%) -com doença clínica (73,1%), menores de 12 meses de idade (40,4%) e eutróficos (69,5%). O índice geral de mortalidade foi de 7,4%. Os pacientes menores de 12 meses de idade mostraram um RR de 1,86 (CI 1,65-2,10; p<0,0001), enquanto que a desnutrição mostrou um RR de 2,98 (IC 2,36; p<0,0001

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Predictors of outcome in severely head-injured children

Cited by 171 publications

References 24 publications

Severe traumatic brain injury in pediatric patients: treatment and outcome using an intracranial pressure targeted therapy—the Lund concept

Severe traumatic brain injury in pediatric patients: treatment and outcome using an intracranial pressure targeted therapy—the Lund concept

Cerebral Blood Flow and Autoregulation After Pediatric Traumatic Brain Injury

Perfil epidemiológico de dezesseis anos de uma unidade de terapia intensiva pediátrica

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