Time of hypotension and discharge outcome in children with severe traumatic brain injury

Journal of Neurotrauma
Uma B SamantM S Vavilala

Abstract

We performed a retrospective study at a level I pediatric trauma center of patients admitted between 1998 and 2005 to determine the time after severe pediatric traumatic brain injury (TBI) that hypotension (systolic blood pressure [SBP] of <5th percentile) is most strongly associated with poor outcome. One hundred forty-six patients of <18 years of age with TBI, head Abbreviated Injury Score (AIS) of >or=3, and PICU admission Glasgow Coma Scale (GCS) score of <9 formed the analytic sample. Available SBP readings through the first 72 h after severe TBI were collected. SBP of <5th percentile was defined as hypotension. Discharge Glasgow Outcome Scale (GOS) score of <4 defined poor outcome. Of 146, 59 (40%) patients had discharge GOS of <4 and 12% died. The adjusted risk of poor outcome associated with hypotension stabilized by 8 h (adjusted risk ratio [RR] 1.7; 95% confidence interval [CI] 1.1-2.6) after injury. The risk of poor outcome peaked with hypotension occurring within the first 6 h after injury (RR 2.0, 95% CI 1.3-3.3). Poor discharge GOS was predicted by hypotension occurring during the first 6 h after injury. SBP data beyond the first 6 h did not improve our ability to predict poor discharge GOS. The first 6 h after se...Continue Reading

References

Mar 1, 1975·Lancet·B Jennett, M Bond
Mar 1, 1993·Journal of Pediatric Surgery·F A PigulaD W Vane
Apr 16, 1999·Statistics in Medicine·S van BuurenD L Knook
May 25, 2001·Critical Care Medicine·J R WhiteD G Nichols
Jul 4, 2001·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Y MatsushitaW D Dietrich
Jan 17, 2002·The New England Journal of Medicine·E RiversUNKNOWN Early Goal-Directed Therapy Collaborative Group
Apr 6, 2002·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Antonio ChiarettiConcezio Di Rocco
Jul 9, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·P David AdelsonUNKNOWN World Federation of Pediatric Intensive and Critical Care Societies
Dec 17, 2003·The Journal of Trauma·Monica S VavilalaFrederick P Rivara
Mar 23, 2004·American Journal of Epidemiology·Guangyong Zou
Aug 3, 2004·Pediatrics·UNKNOWN National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents
Aug 4, 2006·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Sarah C DucrocqPierre A Carli

❮ Previous
Next ❯

Citations

Oct 24, 2009·Current Opinion in Pediatrics·Anne-Marie GuerguerianJames S Hutchison
May 14, 2010·Current Opinion in Pediatrics·Eric R Scaife, Kimberly D Statler
Jul 9, 2009·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Patrick M Kochanek, Robert C Tasker
Jul 30, 2011·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Monica S Vavilala
Aug 15, 2009·The Journal of Trauma·Peter A WalkerCharles S Cox
Oct 7, 2015·Neurocritical Care·Rachel GarvinChad M Miller
May 7, 2009·Journal of Neurochemistry·Susanna ScafidiMary McKenna
Mar 31, 2015·Clinical and Experimental Emergency Medicine·Shu-Ling ChongMarcus Eng Hock Ong
Mar 3, 2015·Seminars in Pediatric Neurology·Angela Lumba-Brown, Jose Pineda
Jul 9, 2016·Pediatric Emergency Care·Nithya KannanUNKNOWN PEGASUS (Pediatric Guideline Adherence Outcomes) Study
Sep 25, 2017·Current Opinion in Neurology·Alicia K Au, Robert S B Clark
Feb 7, 2012·Pediatric Emergency Care·Alexander Fraser PitfieldNiranjan Kissoon
Apr 16, 2011·Current Opinion in Anaesthesiology·Guillaume EmeriaudBruno Ozanne
May 20, 2020·Frontiers in Neurology·Lennart RiemannUNKNOWN Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Investigators and Participa

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.