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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Significance of intracranial pressure and cerebral perfusion pressure in severe pediatric traumatic brain injury

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Department of Children Diseases
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Institute for Biomedical Research
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Department of Neurosurgery, Kaunas University of Medicine, Lithuania
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Author to whom correspondence should be addressed.
Medicina 2008, 44(2), 119; https://doi.org/10.3390/medicina44020015
Received: 11 September 2007 / Accepted: 1 February 2008 / Published: 6 February 2008
The aim of the study was to evaluate outcome of children after severe traumatic brain injury treated according to intracranial pressure (ICP)-targeted protocol, to define threshold values of peak ICP and minimal cerebral perfusion pressure (CPP) for decompressive osteoplastic craniotomy, and to determine the relationship between ICP, CPP and long-term outcome in these children. All children admitted to Pediatric Intensive Care Unit of Kaunas University of Medicine Hospital after severe head injury from January 2004 to June 2006 and treated according to ICPtargeted protocol for the management of severe head trauma were prospectively included in the study. Raised ICP was defined as a level higher than 20 mmHg. Minimal CPP was considered to be at a level of 40 mmHg. Outcome was defined using Glasgow Outcome Scale (GOS) at discharge from the hospital and after 6 months. Forty-eight patients (32 boys and 16 girls) were included into the study. Favorable outcome (GOS score of 4 and 5) after 6 months was achieved in 43 (89.6%) cases. Mean peak ICP was 24.2±7.2 mmHg and mean minimal CPP – 53.1±14.7 mmHg. Decompressive craniotomy was performed in 13 cases. Threshold values of peak ICP and minimal CPP for decompressive craniotomy were 22.5 mmHg (area under the curve, 0.880) and 46.5 mmHg (area under the curve, 0.898), respectively. The differences in peak ICP and minimal CPP in groups of favorable and unfavorable outcomes were not statistically significant. Treating children after severe traumatic brain injury according to the ICP-targeted protocol for the management of severe pediatric traumatic brain injury resulted in a favorable long-term outcome.
Keywords: cerebral perfusion pressure; intracranial pressure; decompressive craniotomy; severe head injury cerebral perfusion pressure; intracranial pressure; decompressive craniotomy; severe head injury
MDPI and ACS Style

Grinkevièiûtë, D.E.; Këvalas, R.; Matukevièius, A.; Ragaiðis, V.; Tamaðauskas, A. Significance of intracranial pressure and cerebral perfusion pressure in severe pediatric traumatic brain injury. Medicina 2008, 44, 119.

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