Abstract
Objectives: Prognostic value of intracranial pressure (ICP) is discussed in the recent literature. The aim of our study was to find the parameter that could be representative of ICP variations and might become a good predictor of severe traumatic brain injury (TBI) outcomes in children.
Materials and methods: The study included 81 patients with severe TBI (2004–2014). Inclusion criteria: GCS ≤ 8, age > 3 years old, admission time to our clinic <24 h from the time of injury. Mean daily values of ICP were used as a predictor, Glasgow outcome scale value was used as a grouping variable. Outcomes were assessed 6 months after injury.
Results: Total mortality was 27%. We have entered the indicator “energy ICP” (E 2), which describes the dynamics of the process and energy. E 2 value in the group of survivors was <500 mmHg2; the probability of accurate forecasting was 91%. Sensitivity, 0.9; specificity; 0.94.
Conclusions: The proposed method is accessible and easy to perform. This method has high specificity in the prediction of severe traumatic brain injury outcome and can be a reliable tool for ICP control.
References
De Silva MJ, Roberts I, Perel P, Edwards P, Kenward MG, Fernandes J, Shakur H, Patel V. Patient outcome after traumatic brain injury in high-, middle- and low-income countries: analysis of data on 8927 patients in 46 countries. Int J Epidemiol. 2009;38:452–8.
Kochanek PM, Carney N, Adelson PD, et al. Guidelines for acute medical management of severe traumatic brain injury in infants, children, and adolescents—second edition. Pediatr Crit Care Med. 2012;13(Suppl 1):S1–82.
Guidelines for the management of severe traumatic brain injury. J Neurotrauma. 2007;24(Suppl 1):S1–106.
Krylov VV, Petrikov SS, Talypov AE, et al. Modern principles of surgery of severe traumatic brain injury. J Emerg Med Care. 2013;4:39–47.
Potapov AA, Krylov VV, Lichterman LB, et al. Modern recommendations of the diagnosis and treatment of severe traumatic brain injury. J Voprosy Neurochirurgii. 2006;1:S.3–8.
Allen BB, Chiu YL, Gerber LM, Ghajar J, Greenfield JP. Age-specific cerebral perfusion pressure thresholds and survival in children and adolescents with severe traumatic brain injury. Pediatr Crit Care Med. 2014;15(1):62–70.
Bruce DA, Alavi A, Bilaniuk L, et al. Diffuse cerebral swelling following head injuries in children: the syndrome of “malignant brain edema”. J Neurosurg. 1981;54:170–8.
Chambers IR, Tradwell L, Mendelow AD. The cause and incidence of secondary insults in severely head-injured adults and children. Br J Neurosurg. 2000;14:424–31.
Miller Ferguson N, Shein SL, Kochanek PM, Luther J, Wisniewski SR, Clark RS, Tyler-Kabara EC, Adelson PD, Bell MJ. Intracranial hypertension and cerebral hypoperfusion in children with severe traumatic brain injury: thresholds and burden in accidental and abusive insults. Pediatr Crit Care Med. 2016;17(5):444–50.
Chesnut RM, Marshall LF, Klauber MR, et al. The role of secondary brain injury in determining outcome from severe head injury. J Trauma. 1993;34:216–22.
Shafi S, Diaz-Arrastia R, Madden C, Gentilello L. Intracranial pressure monitoring in brain-injured patients is associated with worsening of survival. J Trauma Fed. 2008;64(2):335–40.
Grinkeviciute DE, Kevalas R, Matukevicius A, et al. Significance of intracranial pressure and cerebral perfusion in severe pediatric traumatic brain injury. Medicina (Kaunas). 2008;44:119–25.
Vik A, Nag T, Fredriclsi OA, Scandsen T, et al. Relationship of “dose” of intracranial hypertension to outcome in severe traumatic injury. J Neurosurg. 2008;109:678–84.
Kahraman S, Dutton RP, Hu P, Xiao Y, Aarabi B, Stein DM, Scalea TM. Automated measurement of “pressure times time dose” of intracranial hypertension best predicts outcome after severe traumatic brain injury. J Trauma. 2010;69(1):110–8.
Disclosure
The study was approved and supported by the Review Board of Clinical and Research Institute of Emergency Children’s Surgery and Trauma, Moscow, Russia.
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We declare that we have no conflict of interest.
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Semenova, Z.B., Lukianov, V.I., Meshcheryakov, S.V., Roshal, L.M. (2018). Mean Square Deviation of ICP in Prognosis of Severe TBI Outcomes in Children. In: Heldt, T. (eds) Intracranial Pressure & Neuromonitoring XVI. Acta Neurochirurgica Supplement, vol 126. Springer, Cham. https://doi.org/10.1007/978-3-319-65798-1_8
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