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Published on: March 26, 2019
[Neuromonitoring of severe craniocerebral trauma in paediatric patients]
Daisy Abreu Pérez1, Angel Jesús Lacerda Gallardo2, Julio Antonio Díaz Agramonte2
1Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario "Roberto Rodríguez" de Morón, Ciego de Ávila, Cuba.
Insights
Continuous neuromonitoring of intracranial pressure in children with severe head trauma correlates with outcomes. Early intervention, like decompressive craniectomy, helps manage intracranial hypertension and improve patient handling.
Area of Science:
- Pediatric critical care medicine
- Neurotrauma research
- Intensive care unit management
Context:
- Severe craniocerebral trauma is a leading cause of child mortality globally.
- Neuromonitoring is not standard practice in Cuban pediatric intensive care units.
- A standardized protocol for neuromonitoring in pediatric head trauma is lacking.
Purpose:
- To investigate the role of continuous neuromonitoring in managing severe craniocerebral trauma in pediatric patients.
- To establish correlations between neuromonitoring parameters and patient outcomes.
- To evaluate the effectiveness of early interventions guided by neuromonitoring.
Summary:
- A prospective longitudinal study monitored intracranial pressure and cerebral perfusion pressure in pediatric patients with severe head trauma.
- Results indicated a correlation between initial CT scan findings and midline shift, and a direct relationship between intracranial pressure and outcomes.
- Early decompressive craniectomy was found to effectively control intracranial hypertension.
Impact:
- Continuous neuromonitoring aids in adopting effective therapeutic strategies for pediatric severe head trauma.
- This study highlights the importance of implementing standardized neuromonitoring protocols in pediatric intensive care.
- Findings can inform clinical practice and improve outcomes for critically injured children.
Introduction:
Severe craniocerebral trauma is the main cause of morbidity and mortality in children worldwide. Neuromonitoring of these patients in Cuba is not routine in paediatric intensive cares units, and there is no standardised protocol for its use in these units.
Materials And Methods:
A correlational longitudinal prospective study was conducted on all patients admitted to the paediatric intensive care unit with the diagnosis of severe craniocerebral trauma in the period between January 2003 and December 2014. Continuous neuromonitoring of intracranial pressure and cerebral perfusion pressure was carried out.
Results:
The results showed that there was a correlation between the initial images of CT scan and the grade of shift of the half line structures. There was a direct relationship between intracranial pressure and the outcomes. The use of early decompressive craniectomy facilitated the rapid control of the intracranial hypertension.
Conclusions:
Continuous neuromonitoring contributes to adopt a therapeutic posture in the handling of the paediatric patients with severe head trauma.
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