Survey of resources available to implement severe pediatric traumatic brain injury management guidelines in low and middle-income countries

ESICM LIVES 2022: part 2

“…Effectiveness of these ICU specialized care teams team have been critical determinants of quality and outcomes (1)(2)(3). Though, evidence regarding maintaining the physical presence of intensivists at the bedside 24/7 effect on outcomes vary (2,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Optimal critical care delivery is also progressively reliant on advancing technologies.…”

“…This method includes all environmental inputs and outputs from the harvesting of resources up to the disposal of the Introduction: Electronic Critical Care Information Systems (CCIS) used in intensive care medicine can increase the quality of care (1-3), e.g. by simplifying treatment through overview of different automatically taken vital signs (4,5), saving documentation time (6)(7)(8)(9)(10), reducing medication errors (11)(12)(13)(14)(15) and decreasing adverse drug events (16,17). In addition, they may also increase staff-perceived quality of documentation (8) and care (1-3) and increase job satisfaction (18,19).…”

“…However, the influence of environment on delirium is less well studied in the field. In the past only the direct effects of light intensity and noise level at affecting patient's delirium have been investigated but their results were inconclusive [13][14][15][16][17][18]. Objectives: The aim of the project was to identify the primary clinical variables and environmental variables that can independently predict multiclass delirium outcomes of adult ICU patients using logistic regression.…”

“…Median time from hospital admission to ICU admission was 3 (IQR:1-7) days. Regarding outcomes, median hospital stay was 14 (IQR: [10][11][12][13][14][15][16][17][18][19][20][21][22] days; days on IMV, 9 (IQR:5-17) days, and…”

An exploratory assessment of the management of pediatric traumatic brain injury in three centers in Africa

“…In terms of therapies for ICH, hypertonic saline infusion represents a promising therapy for suspected ICH in patients with TBI in LMICs due to its relative affordability, availability of point-of-care testing for blood sodium, and reports of safe peripheral administration and favorable hemodynamic profile compared to mannitol ( 26 – 29 ). Indeed, LMICs have reported increasing availability and safe use of hypertonic saline in children with TBI ( 30 , 31 ). Of note, in our cohort, mannitol, not hypertonic saline, was the most frequently used hyperosmolar therapy due to lack of availability.…”