| Admission oxygenation and ventilation parameters associated with discharge survival in severe pediatric traumatic brain injury. | |
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MedLine Citation:
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PMID: 23207977 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: Current Brain Trauma Foundation guidelines recommend avoiding hypoxemia after severe pediatric traumatic brain injury (TBI). Yet, recent studies on optimum admission oxygenation and ventilation parameters associated with discharge survival in pediatric TBI are lacking. MATERIALS AND METHODS: After IRB approval, a retrospective study involving pediatric patients ages ≤14 years with severe TBI (head Abbreviated Injury Scale (AIS) score of ≥3, Glasgow Coma Scale score of ≤8 on admission) admitted to Harborview Medical Center (level 1 pediatric trauma center), Seattle, WA, during 2003 to 2007 was performed. Admission demographics, clinical data, and laboratory characteristics were abstracted. Hypoxemia was defined as PaO(2) < 60 mmHg, hypocarbia was defined as PaCO(2) ≤ 35 mmHg, and hypercarbia was defined as PaCO(2) ≥ 46 mmHg. RESULTS: One hundred ninety-four patients met inclusion criteria of which 162 (83.5 %) patients survived. Admission hypoxemia occurred in nine (5.6 %) patients who survived and eight (25 %) patients who died (p < 0.001). Children with admission PaCO(2) between 36 and 45 mmHg had greater discharge survival compared with those with both admission hypocarbia (PaCO(2) ≤ 35 mmHg) and hypercarbia (PaCO(2) ≥ 46 mmHg). Admission PaO(2) 301-500 mmHg (adjusted odds ratio (AOR), 8.02 (95 % confidence interval (CI), 1.73-37.10); p = 0.008) and admission PaCO(2) = 36-45 mmHg (AOR, 5.47 (95 % CI, 1.30-23.07); p = 0.02) were independently associated with discharge survival. CONCLUSIONS: Discharge survival after severe pediatric TBI was associated with admission PaO(2) 301-500 mmHg and PaCO(2) = 36-45 mmHg. Admission hypocarbia and hypercarbia were each associated with increased discharge mortality. |
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Authors:
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Vijay Kumar Ramaiah; Deepak Sharma; Li Ma; Sumidtra Prathep; Noah G Hoffman; Monica S Vavilala |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-4 |
Journal Detail:
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Title: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Volume: - ISSN: 1433-0350 ISO Abbreviation: Childs Nerv Syst Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503227 Medline TA: Childs Nerv Syst Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Anesthesiology and Pain Medicine, Harborview Medical Center, 325 Ninth Avenue, PO Box 359724, Seattle, WA, 98104, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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