Relationship of pre-hospital clinical status with behavior of intracranial pressure and outcomes in pediatric patients with severe head trauma.


  • Daysi Abreu Pérez Hospital General Docente "Roberto Rodríguez". Morón Ciego de Ávila, Cuba.
  • Angel Jesus Lacerda Gallardo Hospital General Docente "Roberto Rodríguez"
  • Jose Antonio Galvez. Hospital General Docente "Roberto Rodríguez". Morón Ciego de Ávila, Cuba.


Palabras clave:

arterial hypotension, hypoxia, intracranial pressure, severe head trauma.


Introduction: The prehospital phase of the management of pediatric severe traumatic brain injury may have a direct influence on the results. Objective: To evaluate the influence of prehospital variables on intracranial pressure and the results in pediatric patients with severe TBI. Method: A descriptive study of 41 pediatric patients who were admitted to the medical emergency department and later admitted to the pediatric intensive care unit due to severe head trauma was carried out between January 2003 and December 2018. Results: children aged 5-17 years predominate, and the highest number of cases were received between 0-3h at the neurotrauma center. Of the 41 cases, 27 arrived with a non-expedited airway and hypoxia was verified upon arrival by pulse oximetry. A correlation was observed between arterial hypotension on admission and elevated intracranial pressure in 9 of 15 children (60%) and in the deceased (40%). Discussion: Clinical conditions, oxygenation, arterial hypotension, and treatment in the prehospital phase may influence the state of intracranial pressure and other intracranial variables in pediatric patients with severe head injury.


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Dewan MC, Mummareddy N, Wellons JC, Bonfield CM. Epidemiology of Global Pediatric Traumatic Brain Injury: Qualitative Review. World Neurosurg 2016;91:497–509.e1.

Hankinson TC, Beauchamp K. Pediatric Traumatic Brain Injury: The Global View. World Neurosurg 2016; 92:540–541.

Oliva MO, Maya BD. Traumatismo craneoencefálico grave en Pediatría. An Med (Mex) 2016;61(4):261-70. URL.

Centers for Disease Control Prevention: REPORT to CONGRESS: the Management of Traumatic Brain Injury in Children: Opportunities for Action. Atlanta, GA: National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention, 2018. URL.

Lacerda Gallardo AJ, Abreu Pérez D. Traumatismo craneoencefálico en pediatría. Nuestros resultados. REV NEUROL 2003; 36 (2): 108-12.

Dash HH, Chavali S. Management of traumatic brain injury patients. Korean J Anesthesiol 2018; 71(1):12-21.

Kassi AAY, Mahavadi AK, Clavijo A, Caliz D, Lee SW, Ahmed AI, et al. Enduring neuroprotective effect of subacute neural stem cell transplantation after penetrating TBI. Front Neurol. 2019;9:1097.

Volpi PC, Robba C, Citerio G. Trajectories of early secondary insults correlate to outcomes of traumatic brain injury: results from a large, single centre, observational study. BMC Emergency Medicine 2018;18:52.

Cruz LAM, Ugalde VA, Aparicio ACA, Contreras LLY, Carnalla CM, Choreo PJA, et al. Abordaje del paciente con traumatismo craneoencefálico: un enfoque para el médico de primer contacto. Aten Fam 2019;26(1):28-33.

Hammer G, Lindsay JN. The neurosurgical pediatric patient. In: Andrews BT Eds: Neurosurgical intensive care, McGraw-Hill, New York, 1993: 227-42. URL.

Arjona VD, LLedín BM. Valores normales de la función hemodinámica. En Ruza TF. Manual de cuidados intensivos pediátricos. Sección 2 Técnicas. Capítulo 13; 2010:302-304

Sarnaik A, Ferguson NM, O'Meara AMI, Agrawal S, Deep A, Buttram S, et al. Age and Mortality in Pediatric Severe Traumatic Brain Injury: Results from an International Study. Neurocrit Care 2018;28(3):302-313.

Vavilala MS, Lujan SB, Qiu Q, Bell MJ, Ballarini NM, Guadagnoli N, et al. Intensive care treatments associated with favorable discharge outcomes in Argentine children with severe traumatic brain injury: For the South American Guideline Adherence Group. PLoS One. 2017; 12(12): e0189296.

Kayhanian S, Young AM, Ewen RL, Piper RJ, Guilfoyle MR, Donnelly J, et al. Thresholds for identifying pathological intracranial pressure in paediatric traumatic brain injury. Scientific Reports 2019;9:3537.

Chaitanya K, Addanki A, Karambelkar R, Ranjan R. Traumatic brain injury in Indian children. Childs Nervs Syst 2018;34(6):1119-23.

Labrada DA, Lisabet RD, Martínez CLL. Factores de riesgo de mortalidad en pacientes politraumatizados. Rev Cub Anest Rean internet 2018;17(3). URL.

Álvarez MV, Pérez AD. Factor tiempo en la atención inicial del paciente politraumatizado. Rev Med Electrón internet 2020;42(3):1804-1814. URL.

Newgard CD, Schmicker RH, Hedges JR, et al. Emergency medical services intervals and survival in trauma/ Assessment of the “golden hour” in a north american prospective cohort. Ann Emerg Med 2010; 55: 235-246.

Ali AB, Fortún MM, Belzunegui OT, Teijeira ÁR, Reyero DD, Cabodevilla GA. Influencia de los tiempos de respuesta prehospitalarios en la supervivencia de los pacientes politraumatizados en Navarra. An. Sist. Sanit. Navar. 2015; 38 (2): 269-278

Haselsberger K, Pucher R, Auer LM: Prognosis after acute subdural or epidural haemorrhage. Acta Neurochir (Wien) 1988; 90:111–116.

Tonetti T, Biondini S, Minardi F, et al. Definition and pathomechanism of the intracranial compartment syndrome. In: Coccolini F, Malbrain ML, Kirkpatrick AW, Gamberini E, editors. Compartment syndrome. Hot topics in acute care surgery and trauma. Cham: Springer; 2021. pp. 7–16.

Lovett ME, O´brien NF, Leonard JR. Children With Severe Traumatic Brain Injury, Intracranial Pressure, Cerebral Perfusion Pressure, What Does it Mean? A Review of the Literature. Pediatr Neurol 2019;94:3-20.

Stiver ST, Manley GT. Prehospital management of traumatic brain injury. Neurosurg Focus 2008;25(4):E5.

Kovacs G, Sowers N. Airway Management in Trauma. Emerg Med Clin N Am 2018;36:61–84

Davis DP, Hwang JQ, Dunford JV: Rate of decline in oxygen saturation at various pulse oximetry values with prehospital rapid sequence intubation. Prehosp?Emerg?Care 2008;12:46–51.

Gravesteijn BY, Aletta SC, Stocchetti N, Citerio G, Ercole A, Floor LH. Prehospital management of traumatic brain injury across Europa: A center TBI study. Prehospital Emergency Care 2021;25(5).

Pakkanen T, Nurmi J, Huhtala H, Silfvast T. prehospital on-scene anaesthetist treating severe traumatic brain injury patients is associated with lower mortality and better neurological outcome. Scand J Trauma Resusc Emerg Med 2019;27(1):9.

Spaite DW, Hu C, Bobrow BJ, Chikani V, Barnhart B, Gaither JB, et al. The Effect of Combined Out-of-Hospital Hypotension and Hypoxia on Mortality in Major Traumatic Brain Injury. Ann Emerg Med 2017;69(1):62-72.

Carreón González H. Repercusión social en la persona con traumatismo craneoencefálico. Rev Enferm Inst Mex Seguro Soc. 2017;25(2):133-8. URL.

Alberto EC, Harvey AR, Amberson MJ, Zheng Y, Thenappan AA, Oluigbo C, et al. Assessment of Non-Routine Events and Significant Physiological Disturbances during Emergency Deparment Evaluation after Pediatric Head Trauma. Neurotrauma Rep 2021;2(1):39-47.

Manley G, Knudson M, Morabito D, Damron S, Erickson V, Pitts L. Hypotension, hypoxia and head injury. Frequency, duration, and consequences. Arch Surg 2001;136:1118-23.

Valdez ZJF, Marín CAW, Muñoz AVA, Minda RJA. Atención pre hospitalaria en traumatismo craneoencefálico. Rev Científ Mundo Investig Conoc 2019,3(3): 183-200.

Ramos VY, García BE, Pájaro MR, Moscote SLR. Atención prehospitalaria en el trauma cerebral. Rev Cuban Med Int Emerg 2018;17(0):1-7. URL.

Abreu PD, Lacerda GAJ, Agramonte DJA, Martín CD. Neuromonitorización en el trauma craneoencefálico grave en pediatría. Neurocirugía 2016;27(4):176-184.






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