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A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
Multidisciplinary Perioperative Care of a One-Month-Old Infant With Severe Traumatic Brain Injury and Brain
Zhenjin Cai1,2, Hao Zheng3, Si Wei1,2
1School of Nursing, Hunan University of Chinese Medicine, Changsha, China.
Insights
Structured nursing care, adapted for infants, successfully managed severe traumatic brain injury (sTBI) in a one-month-old. This approach facilitated recovery and improved outcomes for this vulnerable population.
Area of Science:
- Pediatric critical care medicine
- Neuroscience nursing
- Trauma surgery
Background:
- Severe traumatic brain injury (sTBI) is a leading cause of death and disability in children.
- Infants with sTBI present unique challenges due to physiological immaturity and limited evidence-based protocols.
- Existing guidelines for pediatric sTBI often lack infant-specific modifications.
Abstract:
Severe traumatic brain injury (sTBI) is a major cause of trauma-related mortality and disability in children. Infants face unique challenges due to physiological immaturity and scarce evidence-based protocols. We report the perioperative nursing management of a one-month-old infant with sTBI complicated by brain herniation, guided by a multidisciplinary team (MDT) through a structured care pathway adapted from the Third Edition of the Guidelines for the Management of Pediatric Severe Traumatic Brain Injury with infant-specific modifications. The patient presented with respiratory and circulatory failure, severe infection and temperature imbalance. Nursing priorities focussed on neuroprotective interventions targeting intracranial pressure control, comprehensive physiological support and family-centred early rehabilitation incorporating psychosocial support. The infant recovered without critical complications, achieving stable physiological parameters and neurological improvement before discharge on postoperative day 28. This case demonstrates that structured nursing care, integrating individualised multidimensional strategies, can facilitate recovery in infants with sTBI. As few reports address comprehensive nursing paradigms for this age group, our experience provides a practical framework for critical care nursing of infant sTBI patients. RELEVANCE TO CLINICAL PRACTICE: This case establishes a reproducible multidisciplinary team-coordinated care pathway for infant severe traumatic brain injury, integrating infant-tailored neuroprotection, comprehensive physiological support and family-centred early rehabilitation. It highlights the scientific adaptation of existing guidelines to individualised conditions. By providing a practical framework for implementing structured nursing strategies, this approach addresses the critical gap in age-specific protocols to optimise neurodevelopmental outcomes in similar high-risk infants.

