Traumatic brain injury in pediatric age group; predictors of outcome in Pediatric Intensive Care Unit

This prospective observational study quantified screen media use within the night-time pre-sleep period in a pediatric intensive care unit and postulated possible implications. Seventy-five patients between the ages of newborn to 19 years old were observed 5 evenings per week for 3 weeks. Trained observers documented the patient’s screen use, type of screen used, screen engagement, sleep state, light level, and parental presence. Patients in the ICU had on average 65 minutes of screen media use, per evening. The total screen media use averaged 59 minutes for the 0 to18-month age group; 83 minutes for the 18 to 24-month age group; 66 minutes for 2 to 6 year olds; 72 minutes for 6 to 13 year olds; and 74 minutes for those above 13. This research demonstrates that children are engaging in more screen time during the night hours than is recommended by the AAP.

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Predictors of outcome in critically Ill children admitted to a pediatric intensive care unit at a tertiary care centre in Western Maharashtra

JOURNAL OF PEDIATRIC CRITICAL CARE ◽

10.21304/2018.0501.00284 ◽

2018 ◽

Vol 5 (7) ◽

pp. 80

Author(s):

Lakshmi Shobhavat ◽

Rekha Solomon ◽

Radhika Kolpuke ◽

Mehmood Sayyad

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critically Ill ◽

Pediatric Intensive Care Unit ◽

Tertiary Care ◽

Pediatric Intensive Care ◽

Critically Ill Children ◽

Care Centre ◽

Predictors Of Outcome ◽

Tertiary Care Centre

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Traumatic Brain Injury: Comparison of Computed Tomography Findings in Pediatric and Adult Populations

Indian Journal of Neurosurgery ◽

10.1055/s-0040-1708066 ◽

2020 ◽

Vol 9 (03) ◽

pp. 151-156

Author(s):

Madhur Choudhary ◽

Khursheed Alam Khan ◽

Nandkishore Gora ◽

Achal Sharma ◽

Virendra Deo Sinha

Keyword(s):

Computed Tomography ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Clinical Care ◽

Acute Subdural Hematoma ◽

Age Group ◽

Pediatric Age ◽

Pediatric Age Group ◽

Ct Brain ◽

Ct Finding

Abstract Introduction Traumatic brain injury (TBI) is a global health issue, accounting for a significant number of adult and pediatric deaths and morbidity. Computed tomography (CT) is an important diagnostic modality for TBI. The primary goal of this study was to determine if there were any significant radiological differences in CT brain findings between adult and pediatric populations. Materials and Methods Data of individual patients were collected from admission to discharge/death, which included various parameters in terms of demographics, mechanism of injury, and patient outcome which were later analyzed. A total of 1,150 TBI patients were enrolled in the study. Results The most common mode of injury in adults is road traffic accident (RTA) followed by fall from height (FFH), while in pediatrics it is vice versa. Findings of basal cisterns on CT brain were found to be statistically significant in both groups; 65% adults and 71% pediatrics had only one abnormal CT finding. Most common combination CT finding in adults was acute subdural hematoma (ASDH) and basal cistern abnormality, while in pediatrics it was traumatic subarachnoid hemorrhage (SAH) and contusion. Rotterdam score (based on CT brain findings) was significantly lower for pediatric age group compared with adults. It was 2.2 ± 0.85 for adults and 1.99 ± 0.74 for pediatrics, which was statistically significant (p < 0.001). Conclusions The Rotterdam score has immense predictive power for prognostication of mortality status. Pediatric age group has better prognosis in terms of survival as compared with adults, thus justifying the role of Rotterdam CT score for mortality risk stratification in providing clinical care.

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A Prospective Analysis of Derangement of Coagulation Profile in Adult and Pediatric Age Group in Moderate-to-Severe Traumatic Brain Injury

Indian Journal of Neurotrauma ◽

10.1055/s-0038-1676556 ◽

2018 ◽

Vol 15 (02/03) ◽

pp. 087-093

Author(s):

Swarup Sohan Gandhi ◽

Manish Mann ◽

Shashikant Jain ◽

Ugan Singh Meena ◽

Virendra Deo Sinha

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Pediatric Patients ◽

Age Groups ◽

Age Group ◽

Pediatric Age ◽

Coagulation Profile ◽

Pediatric Age Group ◽

Severe Tbi

Abstract Background and Aim of Study Coagulopathy is a common occurrence following traumatic brain injury (TBI). Various studies have reported the incidence and risk factors of coagulopathy and their correlation with poor outcome in adult as well as pediatric age group. In our study, we aim to analyze trauma-induced coagulopathy in adult and pediatric patients. Methods Adult (> 18 years) and pediatric (< 18 years) patients of TBI admitted in the intensive care unit of a trauma center of a tertiary care center had been studied from August 2015 to March 2018. Patients were further subdivided into moderate and severe TBI based on Glasgow Coma Scale (GCS) of 9 to 12 and < 9, respectively. Coagulation profile (prothrombin time [PT], activated partial thromboplastin time [APTT], thrombin time, fibrinogen, and D-dimer) and arterial blood gas (ABG) analysis were done on day of admission and on days 3 and 7. Coagulation profiles were analyzed in both the age groups, and risk factors were studied and correlated with the mortality and morbidity based on the Glasgow outcome score. Results Two hundred patients including 143 adults and 57 pediatric patients were included. Mean age among the adult and pediatric population was 31.51 ± 16.83 and 11.5 ± 5.90 years, respectively. In adults, 96 (83.62%) out of 116 in severe TBI group and 20 (74.07%) out of 27 in moderate TBI group developed coagulopathy, and in pediatric age group, 14 (70%) out of 20 in moderate TBI and 30 (81.08%) out of 37 in severe TBI developed coagulopathy. Midline shift was significantly associated with coagulopathy in both the age groups (p value < 0.039). Mortality was not significantly different in patients with coagulopathy between the age groups, but improved status as per the Glasgow outcome score was more in pediatric age group. Conclusion The development of coagulopathy is a frequent complication in patients with moderate to severe TBI in both age groups. Even though it is not closely associated with death in this study, it may be regarded as a marker of injury severity.

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