Treatment of severe traumatic brain injury in German pediatric intensive care units—a survey of current practice

Regensburger A, Konrad V, Trollmann R, Eyüpoglu IY, Huebner H, Zierk J, Voelkl TMK, Fahlbusch FB (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Childs Nervous System Springer Verlag (Germany)

Book Volume: 35

Pages Range: 815-822

Journal Issue: 5

DOI: 10.1007/s00381-019-04098-z

Abstract

Purpose: German pediatric guidelines for severe traumatic brain injury (TBI) management expired in 2011. Thus, divergent evidence-based institutional protocols are predominantly being followed. We performed a survey of current Pediatric Intensive Care Unit (PICU) management of isolated severe TBI in Germany to reveal potential varying practices. Methods: Seventy German PICUs were invited to join an anonymous online survey from February to May 2017. Twenty-nine participants (41.4%) successfully completed the survey (17 university hospitals and 12 district hospitals). The majority of items were polar (yes/no) or scaled (e.g., never - always). Main topics were imaging, neurosurgery, neuromonitoring, adjuvant therapy, and medication. Severity of TBI was defined via Glasgow Coma Scale. Results: The majority of respondents (93.1%) had internal TBI standards, and patients were mainly administered to interdisciplinary trauma units. The use of advanced neuromonitoring techniques, intracranial hypertension management, and drug treatment differed between PICUs. Routine administration of hypertonic saline in TBI-associated cerebral edema was performed by 3.4%, while it was never an option for 31.0% of the participants. Prophylactic anticonvulsive therapy was restrictively performed. If indicated, the main anticonvulsive drugs used were phenobarbital and levetiracetam. Neuroendocrine follow-up was recommended/performed by 58.6% of the PICUs. Conclusions: This survey provides an overview of the current PICU practices of isolated severe TBI management in Germany and demonstrates a wide instrumental and therapeutical range, revealing an unmet need for the revised national guideline and further (international) clinical trials for the treatment of severe TBI in pediatrics.

Authors with CRIS profile

Adrian Regensburger Department of Paediatrics and Adolescent Medicine Regina Trollmann Professur für Kinder- u. Jugendmedizin Schwerpunkt Neuropädiatrie Ilker Yasin Eyüpoglu Department of Neurosurgery Jakob Zierk Department of Paediatrics and Adolescent Medicine

Additional Organisation(s)

Interdisziplinäres Zentrum für Klinische Forschung

Related research project(s)

J089: Multispectral optoacoustic tomography for non invasive characterization of strictures in Crohn’s disease Jan. 1, 2021 - March 31, 2024

Involved external institutions

Josefinum Augsburg DE Germany (DE) Institut für Frauengesundheit GmbH DE Germany (DE)

How to cite

APA:

Regensburger, A., Konrad, V., Trollmann, R., Eyüpoglu, I.Y., Huebner, H., Zierk, J.,... Fahlbusch, F.B. (2019). Treatment of severe traumatic brain injury in German pediatric intensive care units—a survey of current practice. Childs Nervous System, 35(5), 815-822. https://dx.doi.org/10.1007/s00381-019-04098-z

MLA:

Regensburger, Adrian, et al. "Treatment of severe traumatic brain injury in German pediatric intensive care units—a survey of current practice." Childs Nervous System 35.5 (2019): 815-822.

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