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Mean Square Deviation of ICP in Prognosis of Severe TBI Outcomes in Children
Zhanna B Semenova1, V I Lukianov2, S V Meshcheryakov2
1Clinical and Research Institute of Emergency Children's Surgery and Trauma, St. Bolshaya Polyanka 22, 119180, Moscow, Russia. jseman@mail.ru.
Insights
A new "energy ICP" (E²) metric accurately predicts severe traumatic brain injury outcomes in children. This accessible tool offers high specificity for ICP monitoring and prognosis.
Area of Science:
- Pediatric neurosurgery
- Trauma critical care
- Neurological monitoring
Background:
- Intracranial pressure (ICP) monitoring is crucial for managing severe traumatic brain injury (TBI).
- Identifying reliable predictors of TBI outcomes in children remains a clinical challenge.
Purpose of the Study:
- To identify a parameter representative of ICP variations.
- To evaluate its potential as a predictor for severe TBI outcomes in pediatric patients.
Main Methods:
- Analysis of ICP data from 81 severe TBI patients (age > 3 years, GCS ≤ 8).
- Inclusion of patients admitted within 24 hours of injury.
- Utilized mean daily ICP values and introduced the "energy ICP" (E²) indicator.
Main Results:
- Overall mortality was 27%.
- The E² indicator showed a value <500 mmHg² in survivors.
- Achieved 91% accurate forecasting probability with 0.9 sensitivity and 0.94 specificity.
Conclusions:
- The "energy ICP" (E²) is an accessible and easily applicable method.
- This indicator demonstrates high specificity for predicting severe TBI outcomes in children.
- E² can serve as a reliable tool for ICP management and prognosis.
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.
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