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Updated: Jun 26, 2025
A Novel In Vitro Model of Blast Traumatic Brain Injury
Published on: December 21, 2018
Post-traumatic hyperoxia after pediatric TBI
Si Jie Tang1, Sirjan Mor1, Jeffrey R Fine2
1Department of Neurological Surgery, University of California Davis, Davis, California, USA.
Insights
Hyperoxia, or high oxygen levels, occurred in 33% of pediatric patients with severe traumatic brain injury (TBI). This study found no association between hyperoxia and poor neurological outcomes after six months in these young patients.
Area of Science:
- Pediatric critical care medicine
- Neurotrauma research
- Intensive care unit (ICU) management
Background:
- Hyperoxia is a potential secondary injury mechanism in adult traumatic brain injury (TBI).
- Limited data exists on hyperoxia's impact on neurological outcomes in pediatric TBI patients.
- Understanding hyperoxia's role is crucial for optimizing TBI management in children.
Purpose of the Study:
- To investigate the association between hyperoxia and neurological outcomes in pediatric patients following severe TBI.
- To evaluate the prevalence of hyperoxia in this patient population using multiple assessment methods.
Main Methods:
- Prospective registry of pediatric (≤18 years) TBI patients from October 2008 to April 2022.
- Collected and calculated three measures of hyperoxia (first, highest, AUC PaO2) within 24 hours of ICU admission.
- Assessed neurological outcome at 6 months using modified Rankin Scale (mRS) and Glasgow Outcome Scale - Extended (GOS-E).
- Utilized multivariable logistic regression to control for confounding factors.
Main Results:
- Identified 98 pediatric patients with severe accidental TBI.
- Hyperoxia (PaO2 > 300 mmHg) was present in 33% of patients.
- No significant association was found between any of the three hyperoxia measures and unfavorable neurological outcomes at 6 months.
Conclusions:
- Hyperoxia occurs frequently in pediatric severe TBI patients.
- Despite multiple assessment methods, hyperoxia was not linked to adverse neurological outcomes at 6 months in this cohort.
- Further research may be needed to fully elucidate the role of hyperoxia in pediatric TBI recovery.
Objective:
Hyperoxia has been suggested as a mechanism for secondary injury following adult traumatic brain injury (TBI), but its effects have not been well described in pediatric patients.
Methods:
Pediatric (≤18yo) TBI patients were identified in a prospective institutional registry from October 2008 to April 2022. The first, highest, and the Area Under the Curve (AUC) PaO2 in the first 24 hours were collected and calculated for each patient from arterial blood gas reports after admission to the ICU. Neurological outcome after 6 months was measured using dichotomized modified Rankin Scale (mRS) and Glasgow Outcome Scale - Extended (GOS-E). Multivariable logistic regression models were used to determine if the three measurements for hyperoxia predicted an unfavorable outcome after controlling for well-established clinical and imaging predictors of outcome.
Results:
We identified 98 pediatric patients with severe accidental TBI during the study period. Hyperoxia (PaO2 > 300 mmHg) occurred in 33% of the patients. The presence of elevated PaO2 values, determined by all three evaluations of hyperoxia, was not associated with unfavorable outcome after 6 months.
Conclusion:
Utilizing multiple methods to assess exposure, hyperoxia was present in a substantial number of patients with severe TBI but was not associated with an unfavorable outcome.
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