Severe traumatic brain injury in pediatric patients: treatment and outcome using an intracranial pressure targeted therapy--the Lund concept

Wahlström, Marie Rodling,1960-Umeå universitet,Anestesiologi och intensivvård (author)

OBJECTIVE: This study evaluated the outcome of treatment according to the Lund concept in children with severe traumatic brain injury and investigated whether the preset goals of the protocol were achieved. DESIGN AND SETTING: A two-center retrospective study in neurointensive care units at university hospitals. PATIENTS: Forty-one children with severe traumatic brain injury from blunt trauma and arriving at hospital within 24 h after injury. Median age was 8.8 years (range 3 months-14.2 years), Glasgow Coma Scale 7 (3-8), and Injury Severity Score 25 (16-75). All children had pathological findings on initial computed tomography. All developed intracranial hypertension, and survivors required intensive care longer than 72 h. INTERVENTIONS: Treatment according to the principles of the Lund concept. MEASUREMENTS AND RESULTS: Neurosurgery was required in 46% of the children. Survival rate was 93% and favorable outcome (Glasgow Outcome Score 4 or 5) was 80% at long-term follow-up (median 12 months postinjury, range 2.5-26). The preset physiological and biochemical goals were achieved in over 90% of observations. CONCLUSIONS: Treating pediatric patients with severe traumatic brain injury, according to the Lund concept, results in a favorable outcome when the protocol is followed.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
Adolescent
*Algorithms
Brain Injuries/mortality/physiopathology/*therapy
Child
Child
Preschool
Female
Humans
Infant
Intensive Care Units
*Intracranial Pressure
Male
Retrospective Studies
Statistics
Nonparametric
Survival Rate
Sweden/epidemiology
Wounds
Nonpenetrating/mortality/physiopathology/*therapy
adolescent

Olivecrona, MagnusUmeå universitet,Neurokirurgi(Swepub:umu)masola78 (author)
Koskinen, Lars-Olof (author)
Rydenhag, Bertil,1954Gothenburg University,Göteborgs universitet,Institutionen för klinisk neurovetenskap,Institute of Clinical Neurosciences,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden(Swepub:gu)xrydbe (author)
Naredi, Silvana,1953Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care,Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden(Swepub:umu)nasi0001 (author)
Koskinen, Lars-Owe DUmeå universitet,Neurokirurgi(Swepub:umu)lako0002 (author)
Umeå universitetAnestesiologi och intensivvård (creator_code:org_t)

In:Intensive Care MedHeidelberg : Springer Science and Business Media LLC31:6, s. 832-90342-46421432-1238

By the author/editor: Wahlström, Marie ...; Olivecrona, Magn ...; Koskinen, Lars-O ...; Rydenhag, Bertil ...; Naredi, Silvana, ...; Koskinen, Lars-O ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

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