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Updated: Jul 6, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Evaluation of monitoring critical ill children with traumatic brain injury
Merve Misirlioglu1, Dincer Yildizdas2, Faruk Ekinci2
1Department of Pediatric Intensive Care, Mersin University Faculty of Medicine, Mersin, Türkiye.
Insights
Multidimensional monitoring in pediatric traumatic brain injury (TBI) helps assess cerebral oxygenation and intracranial pressure. Higher optic nerve sheath diameter and intracranial pressure indicate poorer prognosis in TBI patients.
Area of Science:
- Pediatric intensive care
- Neurocritical care
- Traumatic brain injury management
Background:
- Traumatic brain injury (TBI) monitoring is crucial for managing critically ill children.
- Multidimensional monitoring provides insights into cerebral blood flow, oxygenation, and perfusion pressure.
Purpose of the Study:
- To evaluate the effectiveness of multidimensional monitoring in critically ill children with TBI.
- To correlate monitoring parameters with patient prognosis.
Main Methods:
- Retrospective analysis of 28 pediatric TBI patients in a tertiary PICU (2018-2020).
- Monitored parameters included cerebral tissue oxygenation, optic nerve sheath diameter (ONSD), Glasgow Coma Score (GCS), and Glasgow Outcome Score (GOSE).
Main Results:
- Higher ONSD and intracranial pressure (nICP) were associated with poor prognosis on days 1 and 2.
- Cerebral tissue oxygenation decreased significantly by day 2 in both good and poor prognosis groups.
- A significant decrease in ONSD and nICP was observed in the good prognosis group by day 2.
Conclusions:
- Multidimensional monitoring is essential for protecting the brain from primary and secondary damage in TBI.
- Close, multidisciplinary monitoring is recommended for optimal TBI patient management.
Introduction:
In traumatic brain injury (TBI), direct information can be obtained about cerebral blood flow, brain tissue oxygenation and cerebral perfusion pressure values. More importantly, an idea about the changes in these measurements can be obtained with multidimensional monitoring and widely used monitoring methods.
Aim Of The Study:
We aimed to evaluate the monitoring of critically ill children who were followed up in our pediatric intensive care unit (PICU) due to TBI.
Material And Method:
Twenty-eight patients with head trauma who were followed up in our tertiary PICU between 2018 and 2020 were included in the study. Cerebral tissue oxygenation, optic nerve sheath diameter (ONSD), Glasgow coma score (GCS) and Glasgow Outcome Score (GOSE) values were obtained from retrospective file records and examined.
Results:
Male gender was 71.4% (n=20). When we classified TBI according to GCS, 50% (n=14) had moderate TBI and 50% had severe TBI. On the first day in the poor prognosis group, ONSD and nICP were found to be higher than in the good prognosis group (for ONSD, p=0.01; and for nICP, p=0.004). On the second day of hospitalization, the ONSD and nICP were significantly higher in the poor prognosis group than in the good prognosis group (for ONSD p=0.002; and for nICP p= 0.001). Cerebral tissue oxygenation values measured on the first and second days decreased significantly on the second day in both the good and poor prognosis groups (p=0.03, 0.006). In the good prognosis group, a statistically significant decrease was found in ONSD and nICP measurements taken on the 2nd day compared to the measurements taken at the time of hospitalization (for ONSD p=0.004; for nICP p<0.001).
Conclusion:
The aim of multidimensional follow-up in traumatic brain injury is to protect the brain from both primary and secondary damage; for this reason, it should be followed closely with multimonitoring methods that are possibly multidisciplinary.
