Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024
Management of severe traumatic brain injury in pediatric patients: an evidence-based approach.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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de Carvalho Panzeri Carlotti Ana Paula, do Amaral Vivian Henriques, de Carvalho Canela Balzi Ana Paula, Johnston Cintia, Regalio Fabiane Allioti, Cardoso Maíra Freire, Ferranti Juliana Ferreira, Zamberlan Patrícia, Gilio Alfredo Elias, Malbouisson Luiz Marcelo Sá, Delgado Artur Figueiredo, de Carvalho Werther Brunow, Brazilian Pediatric Intensive Care Group
Аннотация
BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and disability worldwide. The decision-making process in the management of severe TBI must be based on the best available evidence to minimize the occurrence of secondary brain injuries. However, healthcare approaches to managing TBI patients exhibit considerable variation.
METHODS: Over an 18-month period, a multidisciplinary panel consisting of medical doctors, physiotherapists, nutritional therapists, and nurses performed a comprehensive review on various subtopics concerning TBI. The panel identified primary questions to be addressed using the Population, Intervention, Control, and Outcome (PICO) format and applied the Evidence to Decision (EtD) framework criteria for evaluating interventions. Subsequently, the panel formulated recommendations for the management of severe TBI in children.
RESULTS: Fourteen evidence-based recommendations have been devised for the management of severe TBI in children, covering nine topics, including imaging studies, neuromonitoring, prophylactic anticonvulsant use, hyperosmolar therapy, sedation and analgesia, mechanical ventilation strategies, nutritional therapy, blood transfusion, and decompressive craniectomy. For each topic, the panel provided clinical recommendations and identified research priorities.
CONCLUSIONS: This review offers evidence-based strategies aimed to guide practitioners in the care of children who suffer from severe TBI.
METHODS: Over an 18-month period, a multidisciplinary panel consisting of medical doctors, physiotherapists, nutritional therapists, and nurses performed a comprehensive review on various subtopics concerning TBI. The panel identified primary questions to be addressed using the Population, Intervention, Control, and Outcome (PICO) format and applied the Evidence to Decision (EtD) framework criteria for evaluating interventions. Subsequently, the panel formulated recommendations for the management of severe TBI in children.
RESULTS: Fourteen evidence-based recommendations have been devised for the management of severe TBI in children, covering nine topics, including imaging studies, neuromonitoring, prophylactic anticonvulsant use, hyperosmolar therapy, sedation and analgesia, mechanical ventilation strategies, nutritional therapy, blood transfusion, and decompressive craniectomy. For each topic, the panel provided clinical recommendations and identified research priorities.
CONCLUSIONS: This review offers evidence-based strategies aimed to guide practitioners in the care of children who suffer from severe TBI.