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Variables affecting outcome from severe brain injury in children
Z Barzilay1, A Augarten, M Sagy
1Pediatric Intensive Care Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Intensive Care Medicine
|January 1, 1988
Summary
Severely brain-injured children with an Initial Glasgow Coma Scale score of 7 or higher had good recovery. High maximal intracranial pressure (ICP max) above 40 torr significantly correlated with mortality in pediatric brain injury.
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
- Neurotrauma
Background:
- Severe brain injury in children presents significant challenges in predicting outcomes.
- Glasgow Coma Scale (IGCS), intracranial pressure (ICP), and cerebral perfusion pressure (CPP) are critical indicators.
Purpose of the Study:
- To evaluate the outcomes of severely brain-injured children.
- To correlate initial and maximal intracranial pressure (ICP max) and minimal cerebral perfusion pressure (CPP min) with survival quality.
Main Methods:
- Study included 56 severely brain-injured children.
- Data collected on IGCS, ICP (initial and maximal), and CPP (minimal).
- Outcome assessed using the Glasgow outcome scale at hospital discharge.
Main Results:
- An IGCS of 3 indicated 100% mortality; scores of 7+ yielded 72% good recovery.
- ICP exceeding 40 torr correlated with poor outcomes and high mortality (93%).
- Head trauma patients with lower ICP max and higher CPP min showed better survival rates.
Conclusions:
- IGCS is a strong predictor of mortality and recovery in pediatric brain injury.
- Elevated ICP max is a critical factor associated with poor outcomes and mortality.
- Maintaining adequate CPP is crucial for survival in severely brain-injured children.