OBJECTIVE: To examine the influence of definition and location (field, emergency department, or pediatric intensive care unit) of hypotension on outcome following severe pediatric traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: Harborview Medical Center (level I pediatric trauma center), Seattle, WA, over a 5-yr period between 1998 and 2003. PATIENTS: Ninety-three children <14 yrs of age with traumatic brain injury following injury, head Abbreviated Injury Score > or = 3, and pediatric intensive care unit admission Glasgow Coma Scale score <9 formed the analytic sample. Data sources included the Harborview Trauma Registry and hospital records. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The relationship between hypotension and outcome was examined comparing two definitions of hypotension: a) systolic blood pressure <5th percentile for age; and b) systolic blood pressure <90 mm Hg. Hospital discharge Glasgow Outcome Score <4 or disposition of either death or discharge to a skilled nursing facility was considered a poor outcome. Pediatric intensive care unit and hospital length of stay were also examined. Systolic blood pressure <5th percentile for age was more highly associated with poor hospital discharge Glasgow Outcome Score (p = .001), poor disposition (p = .02), pediatric intensive care unit length of stay (rate ratio 9.5; 95% confidence interval 6.7-12.3), and hospital length of stay (rate ratio 18.8; 95% confidence interval 14.0-23.5) than systolic blood pressure <90 mm Hg. Hypotension occurring in either the field or emergency department, but not in the pediatric intensive care unit, was associated with poor Glasgow Outcome Score (p = .008), poor disposition (p = .03), and hospital length of stay (rate ratio 18.7; 95% confidence interval 13.1-24.2). CONCLUSIONS: Early hypotension, defined as systolic blood pressure <5th percentile for age in the field and/or emergency department, was a better predictor of poor outcome than delayed hypotension or the use of systolic blood pressure <90 mm Hg.
OBJECTIVE: To examine the influence of definition and location (field, emergency department, or pediatric intensive care unit) of hypotension on outcome following severe pediatric traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: Harborview Medical Center (level I pediatric trauma center), Seattle, WA, over a 5-yr period between 1998 and 2003. PATIENTS: Ninety-three children <14 yrs of age with traumatic brain injury following injury, head Abbreviated Injury Score > or = 3, and pediatric intensive care unit admission Glasgow Coma Scale score <9 formed the analytic sample. Data sources included the Harborview Trauma Registry and hospital records. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The relationship between hypotension and outcome was examined comparing two definitions of hypotension: a) systolic blood pressure <5th percentile for age; and b) systolic blood pressure <90 mm Hg. Hospital discharge Glasgow Outcome Score <4 or disposition of either death or discharge to a skilled nursing facility was considered a poor outcome. Pediatric intensive care unit and hospital length of stay were also examined. Systolic blood pressure <5th percentile for age was more highly associated with poor hospital discharge Glasgow Outcome Score (p = .001), poor disposition (p = .02), pediatric intensive care unit length of stay (rate ratio 9.5; 95% confidence interval 6.7-12.3), and hospital length of stay (rate ratio 18.8; 95% confidence interval 14.0-23.5) than systolic blood pressure <90 mm Hg. Hypotension occurring in either the field or emergency department, but not in the pediatric intensive care unit, was associated with poor Glasgow Outcome Score (p = .008), poor disposition (p = .03), and hospital length of stay (rate ratio 18.7; 95% confidence interval 13.1-24.2). CONCLUSIONS: Early hypotension, defined as systolic blood pressure <5th percentile for age in the field and/or emergency department, was a better predictor of poor outcome than delayed hypotension or the use of systolic blood pressure <90 mm Hg.
Authors: Antonio Chiaretti; Raffaella De Benedictis; Francesco Della Corte; Marco Piastra; Luigi Viola; Giancarlo Polidori; Concezio Di Rocco Journal: Childs Nerv Syst Date: 2001-12-18 Impact factor: 1.475
Authors: Monica S Vavilala; Lorri A Lee; Krishna Boddu; Elizabeth Visco; David W Newell; Jerry J Zimmerman; Arthur M Lam Journal: Pediatr Crit Care Med Date: 2004-05 Impact factor: 3.624
Authors: Richard M Hackbarth; Kim M Rzeszutko; George Sturm; Jacobus Donders; Andrea S Kuldanek; Dominic J Sanfilippo Journal: Crit Care Med Date: 2002-07 Impact factor: 7.598
Authors: Monica S Vavilala; Anna Bowen; Arthur M Lam; Joshua C Uffman; Jeffrey Powell; H Richard Winn; Frederick P Rivara Journal: J Trauma Date: 2003-12
Authors: William M Armstead; J Willis Kiessling; John Riley; Douglas B Cines; Abd Al-Roof Higazi Journal: Neurol Res Date: 2011-09 Impact factor: 2.448
Authors: Kate Liesemer; Jay Riva-Cambrin; Kimberly Statler Bennett; Susan L Bratton; Henry Tran; Ryan R Metzger; Tellen D Bennett Journal: Pediatr Crit Care Med Date: 2014-07 Impact factor: 3.624
Authors: Etienne St-Louis; Jade Séguin; Daniel Roizblatt; Dan Leon Deckelbaum; Robert Baird; Tarek Razek Journal: Pediatr Surg Int Date: 2016-11-21 Impact factor: 1.827