Document Detail


Controversies of prophylactic hypothermia and the emerging use of brain tissue oxygen tension monitoring and decompressive craniectomy in traumatic brain-injured children.
MedLine Citation:
PMID:  20036140     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite being the leading cause of death and disability in the paediatric population, traumatic brain injury (TBI) in this group is largely understudied. Clinical practice within the paediatric intensive care unit (PICU) has been based upon adult guidelines however children are significantly different in terms of mechanism, pathophysiology and consequence of injury. AIM: To review TBI management in the PICU and gain insight into potential management strategies. METHOD: To conduct this review, a literature search was conducted using MEDLINE, PUBMED and The Cochrane Library using the following key words; traumatic brain injury; paediatric; hypothermia. There were no date restrictions applied to ensure that past studies, whose principles remain current were not excluded. RESULTS: Three areas were identified from the literature search and will be discussed against current acknowledged treatment strategies: Prophylactic hypothermia, brain tissue oxygen tension monitoring and decompressive craniectomy. CONCLUSION: Previous literature has failed to fully address paediatric specific management protocols and we therefore have little evidence-based guidance. This review has shown that there is an emerging and ongoing trend towards paediatric specific TBI research in particular the area of moderate prophylactic hypothermia (MPH).
Authors:
Kelly Foster; Christian Stocker; Andreas Schibler
Publication Detail:
Type:  Journal Article; Review     Date:  2009-12-24
Journal Detail:
Title:  Australian critical care : official journal of the Confederation of Australian Critical Care Nurses     Volume:  23     ISSN:  1036-7314     ISO Abbreviation:  Aust Crit Care     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-05-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207852     Medline TA:  Aust Crit Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  4-11     Citation Subset:  N    
Copyright Information:
Copyright 2009 Australian College of Critical Care Nurses Ltd. All rights reserved.
Affiliation:
Paediatric Critical Care Research Group, Paediatric Intensive Care Unit, Mater Children's Hospital, Raymond Terrace, South Brisbane, Queensland 4101, Australia. kelly.foster@mater.org.au
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Brain Chemistry / physiology
Brain Injuries / complications,  epidemiology,  therapy*
Cerebrovascular Circulation / physiology
Child
Critical Care / methods*,  trends
Decompressive Craniectomy* / methods
Dissent and Disputes
Humans
Hypothermia, Induced* / methods
Hypoxia, Brain / diagnosis,  etiology,  metabolism,  prevention & control*
Intensive Care Units, Pediatric
Intracranial Hypertension / etiology,  prevention & control
Monitoring, Physiologic* / methods
Oxygen / analysis,  metabolism
Practice Guidelines as Topic
Treatment Outcome
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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