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Intracranial Pressure Monitoring in Pediatric Traumatic Brain Injury Patients: A National Study
Vishmita Kannichamy1, Kartik Prabhakaran1, Rishwanth Vetri1
1Westchester Medical Center, New York Medical College, Valhalla, New York.
The Journal of Surgical Research
|April 12, 2026
Summary
Intracranial pressure (ICP) monitoring in pediatric traumatic brain injury (TBI) patients is linked to reduced mortality. However, benefits may be concentrated in specific high-risk subgroups of children.
Area of Science:
- Pediatric Neurosurgery
- Trauma Care
- Critical Care Medicine
Background:
- Traumatic brain injury (TBI) is a significant cause of mortality and morbidity in children.
- Intracranial pressure (ICP) monitoring is a critical tool in managing severe TBI.
- The specific benefit of ICP monitoring in pediatric TBI populations requires further elucidation.
Purpose of the Study:
- To determine if ICP monitoring improves survival outcomes in pediatric TBI patients.
- To identify specific pediatric subgroups that benefit most from ICP monitoring.
Main Methods:
- A retrospective review of the American College of Surgeons Trauma Quality Improvement Program (2017-2022) was conducted.
- Pediatric TBI cases (<18 years) were analyzed, excluding those with short hospital stays or severe injuries in other body regions.
- Propensity score matching was used to compare outcomes between patients who underwent ICP monitoring (ICP) and those who did not (NoICP).
Main Results:
- After propensity score matching, 1250 patients were in each group (ICP vs. NoICP).
- The ICP group exhibited significantly lower in-hospital mortality (17.3% vs. 22.7%, P < 0.001).
- The ICP group experienced higher rates of complications and longer intensive care unit (ICU) and hospital lengths of stay (LOS).
Conclusions:
- ICP monitoring is associated with a significant reduction in mortality for pediatric TBI patients.
- The benefits of ICP monitoring are not uniform and appear to be most pronounced in select high-risk pediatric populations.
- Further research should focus on refining criteria for ICP monitoring in pediatric TBI.
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