Traumatic brain injury in children with thoracic injury: clinical significance and impact on ventilatory management
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In brief
In brief
Retrospective study of 75 pediatric chest trauma patients reveals 79% had concurrent TBI, with 41% requiring mechanical ventilation. Ventilatory management for moderate-to-severe TBI did not increase ARDS risk, though all 6 deaths occurred in the TBI cohort.
Written by the GCMD Library team from the article.
Abstract
Purpose
This study aims to describe the epidemiology and management of chest trauma in our center, and to compare patterns of mechanical ventilation in patients with or without associated moderate-to-severe traumatic brain injury (TBI).
Methods
All children admitted to our level-1 trauma center from February 2012 to December 2018 following chest trauma were included in this retrospective study.
Results
A total of 75 patients with a median age of 11 [6–13] years, with thoracic injuries were included. Most patients also had extra-thoracic injuries (n = 71, 95%) and 59 (79%) had TBI. A total of 52 patients (69%) were admitted to intensive care and 31 (41%) were mechanically ventilated. In patients requiring mechanical ventilation, there was no difference in tidal volume or positive end-expiratory pressure in patients with moderate-to-severe TBI when compared with those with no-or-mild TBI. Only one patient developed Acute Respiratory Distress Syndrome. A total of 6 patients (8%) died and all had moderate-to-severe TBI.
Conclusion
In this small retrospective series, most patients requiring mechanical ventilation following chest trauma had associated moderate-to-severe TBI. Mechanical ventilation to manage TBI does not seem to be associated with more acute respiratory distress syndrome occurrence.