Frequency and Indications for Anesthesia Exposure in a Pediatric Traumatic Brain Injury Cohort

Area of Science:

• Neuroscience
• Anesthesiology
• Pediatric Critical Care

Background:

• Pediatric traumatic brain injury (pTBI) is a significant cause of pediatric morbidity.
• Patients with pTBI often require multiple anesthetic exposures (AE) during hospitalization.
• The relationship between repeated AEs and patient outcomes in pTBI is not fully understood.

Purpose of the Study:

• To analyze the hospital course and outcomes of pediatric traumatic brain injury patients.
• To investigate the association between the number of anesthetic exposures (AE) and patient morbidity.
• To determine if repeated AEs increase the risk of adverse outcomes in pTBI patients.

Main Methods:

• Retrospective chart review of pTBI patients from 2012-2021.
• Patients grouped by the number of anesthetic exposures (AE).
• Comparison of hospital course and outcomes, including infection rates and new morbidity.

Main Results:

• Increasing anesthetic exposures (AE) correlated with worse Injury Severity Scores (ISS) and lower Glasgow Coma Scale (GCS).
• Higher AE rates were linked to increased intubation, ICU admission, ICP monitoring, and prolonged hospital stays.
• Multivariate analysis showed AE was associated with higher infection rates and new morbidity.

Conclusions:

• Anesthetic exposure (AE) in pTBI patients is high and associated with increased hospital-acquired infections and new morbidities.
• Multiple anesthetic exposures (AE) in pediatric traumatic brain injury (pTBI) patients are linked to adverse outcomes.
• Controlled trials are necessary to evaluate the risk-benefit of multiple procedures and AEs in pTBI.