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Traumatic Brain Injury

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Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study.
Babl FE, Borland ML, Phillips N, Kochar A, Dalton S, McCaskill M, Cheek JA, Gilhotra Y, Furyk J, Neutze J, Lyttle MD, Bressan S, Donath S, Molesworth C, Jachno K, Ward B, Williams A, Baylis A, Crowe L, Oakley E, Dalziel SR; Paediatric Research in Emergency Departments International Collaborative (PREDICT).
Lancet. 2017 Jun 17;389(10087):2393-2402.

Rationale for inclusion: Multicenter, prospective observational study of children (<18yrs) with head injuries found that PECARN, CATCH and CHALICE rules all effectively identified children with clinically significant head injuries.

CAVEAT: This is not a statistical comparison of these three rules.

Citations - 10 (as of October 2017)

Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension.
Hutchinson PJ, Kolias AG, Timofeev IS, Corteen EA, Czosnyka M, Timothy J, Anderson I, Bulters DO, Belli A, Eynon CA, Wadley J, Mendelow AD, Mitchell PM, Wilson MH, Critchley G, Sahuquillo J, Unterberg A, Servadei F, Teasdale GM, Pickard JD, Menon DK, Murray GD, Kirkpatrick PJ; RESCUEicp Trial Collaborators.
N Engl J Med. 2016 Sep 22;375(12):1119-30.

Rationale for inclusion: 408 patients with traumatic intracranial hypertension were randomized to decompressive craniectomy or medical therapy.  Decompressive craniectomy resulted in lower mortality but greater vegatitive state and severe disability at 6 months.

Citations - 62 (as of July 2017)

Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents--second edition.
Kochanek PM, Carney N, Adelson PD, Ashwal S, Bell MJ, Bratton S, Carson S, Chesnut RM, Ghajar J, Goldstein B, Grant GA, Kissoon N, Peterson K, Selden NR, Tasker RC, Tong KA, Vavilala MS, Wainwright MS, Warden CR; American Academy of Pediatrics-Section on Neurological Surgery; American Association of Neurological Surgeons/Congress of Neurological Surgeons; Child Neurology Society; European Society of Pediatric and Neonatal Intensive Care; Neurocritical Care Society; Pediatric Neurocritical Care Research Group; Society of Critical Care Medicine; Paediatric Intensive Care Society UK; Society for Neuroscience in Anesthesiology and Critical Care; World Federation of Pediatric Intensive and Critical Care Societies.
Pediatr Crit Care Med. 2012 Jan;13 Suppl 1:S1-82.

Rationale for inclusion: These guidelines provide extensive, evidence based recommendations for the management of traumatic brain injury in children.  They are broadly endorsed by major neurosurgery, neurology, pediatric, and critical care professional societies.

CAVEAT: Guidelines

Citations - 25 (as of July 2017)

Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study.
Kuppermann N, Holmes JF, Dayan PS, Hoyle JD Jr, Atabaki SM, Holubkov R, Nadel FM, Monroe D, Stanley RM, Borgialli DA, Badawy MK, Schunk JE, Quayle KS, Mahajan P, Lichenstein R, Lillis KA, Tunik MG, Jacobs ES, Callahan JM, Gorelick MH, Glass TF, Lee LK, Bachman MC, Cooper A, Powell EC, Gerardi MJ, Melville KA, Muizelaar JP, Wisner DH, Zuspan SJ, Dean JM, Wootton-Gorges SL; Pediatric Emergency Care Applied Research Network (PECARN).
Lancet. 2009 Oct 3;374(9696):1160-70.

Rationale for inclusion: This prospective, multi-center, observational study of 42,412 pediatric trauma patients with head injury and GCS of 14-15 validated a clinical prediction rule that identified children at low risk of clinically-important traumatic brain injury for which head CT could be safely avoided.

Citations - 707 (as of July 2017)

Hypothermia therapy after traumatic brain injury in children.
Hutchison JS, Ward RE, Lacroix J, H├ębert PC, Barnes MA, Bohn DJ, Dirks PB, Doucette S, Fergusson D, Gottesman R, Joffe AR, Kirpalani HM, Meyer PG, Morris KP, Moher D, Singh RN, Skippen PW; Hypothermia Pediatric Head Injury Trial Investigators and the Canadian Critical Care Trials Group.
N Engl J Med. 2008 Jun 5;358(23):2447-56.

Rationale for inclusion: This randomized, prospective, multi-center, multinational trial of 225 patients showed that hypothermia initiated within 8 hours of injury and continued for 24 hours did not improve neurologic outcome and could worsen mortality.

Citations - 521 (as of July 2017)

Guidelines for prehospital management of traumatic brain injury 2nd edition.
Badjatia N, Carney N, Crocco TJ, Fallat ME, Hennes HM, Jagoda AS, Jernigan S, Letarte PB, Lerner EB, Moriarty TM, Pons PT, Sasser S, Scalea T, Schleien CL, Wright DW; Brain Trauma Foundation; BTF Center for Guidelines Management.
Prehosp Emerg Care. 2008;12 Suppl 1:S1-52.

Rationale for inclusion: This supplement of Prehospital Emergency Care presents comprehensive, evidence guidelines for the prehospital management of children with traumatic brain injury.

CAVEAT: Guidelines

Citations - 176 (as of July 2017)

Hyperglycemia and outcomes from pediatric traumatic brain injury.
Cochran A, Scaife ER, Hansen KW, Downey EC.
J Trauma. 2003 Dec;55(6):1035-8.

Rationale for inclusion: This retrospective, single center review of pediatric patients with severe TBI showed that hyperglycemia is associated with poor neurologic outcome.

CAVEAT: Single center, retrospective

Citations - 223 (as of July 2017)

A population-based study of inflicted traumatic brain injury in young children.
Keenan HT, Runyan DK, Marshall SW, Nocera MA, Merten DF, Sinal SH.
JAMA. 2003 Aug 6;290(5):621-6.

Rationale for inclusion: This study of 230,000 children aged 2 years and younger showed a higher risk of inflicted traumatic brain injury in males, children of young mothers, non-European Americans, products of multiple births, and younger infants. This paper helped to define risk factors for inflicted traumatic brain injury.

Citations - 410 (as of July 2017)

A prospective study of short- and long-term outcomes after traumatic brain injury in children: behavior and achievement.
Taylor HG, Yeates KO, Wade SL, Drotar D, Stancin T, Minich N.
Neuropsychology. 2002 Jan;16(1):15-27.

Rationale for inclusion: This longitudinal study across four years of behavior and achievement in children with severe traumatic brain injury (N=53), moderate traumatic brain injury (N=56), and controls (N=80, orthopedic injuries) showed persistent sequelae of traumatic brain injury. The study also showed that post-injury improvement can be influenced by the family environment.

Citations - 381 (as of July 2017)

A randomized trial of very early decompressive craniectomy in children with traumatic brain injury and sustained intracranial hypertension.
Taylor A, Butt W, Rosenfeld J, Shann F, Ditchfield M, Lewis E, Klug G, Wallace D, Henning R, Tibballs J.
Childs Nerv Syst. 2001 Feb;17(3):154-62.

Rationale for inclusion: This single center, prospective, randomized  trial of 27 children sustaining severe TBI compared medical management plus decompressive craniectomy to medical management alone. They found that early decompressive craniectomy  improves intracranial pressure and episodes of intracranial hypertension with improved long term neurologic outcome.

CAVEAT: Single center

Citations - 462 (as of July 2017)

Hypertonic saline lowers raised intracranial pressure in children after head trauma.
Fisher B, Thomas D, Peterson B.
J Neurosurg Anesthesiol. 1992 Jan;4(1):4-10.

Rationale for inclusion: This prospective, double-blind, crossover study evaluated the impact of 3% saline compared to 0.9% saline. 3% saline infusion significantly reduced ICP after traumatic brain injury in children. This study help define the role of hypertonic saline in the management of pediatric TBI.

CAVEAT: Single center

Citations - 229 (as of July 2017)

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