Paediatric Brain Monitoring with Information Technology (KidsBrainIT) - ERA-NET NEURON Grant

Abstract The complete name of this ERA-NET NEURON Grant is “Paediatric Brain Monitoring with Information Technology (KidsBrainIT). Using IT Innovations to Improve Childhood Traumatic Brain Injury Intensive Care Management, Outcome, and Patient Safety”. The Project Coordinators are Ms. Dr. Tsz-Yan Milly Lo (Consultant Paediatric Intensivist and Research Lead in Paediatric Critical Care Medicine ) and Ian Piper from University of Edinburgh, UK and the partners are: Prof. Bart Depreitere and his team from Neurosurgery & Intensive Care Research Group, University Hospitals Leuven, Belgium; Prof. Juan Sahuquillo and his team from Department of Neurosurgery, Vall d’Hebron University Hospital, Barcelona, Spain and the Romanian team with doctors CA Apetrei, C Gheorghita and A Tascu as principal investigators in three different hospitals. This material is based on the scientific project proposal with the basic project data. The aim of this grant is to test two clinically relevant hypotheses: after sustaining traumatic brain injury (TBI), paediatric patients with a longer period of measured cerebral perfusion pressure (CPP) maintained within the calculated optimal CPP (CPPopt) have an improved global clinical outcome and better tolerance against raised intracranial pressure (ICP). Paediatric TBI patients requiring intensive care are recruited from more contributing centres in 4 different countries. Their anonymised routinely collected bedside physiological monitoring data in minute-resolutions linking with anonmyised clinical and outcome data are exported and archived in the central KidsBrainIT data-bank. CPPopt is calculated and ICP dose-response analyses are performed on the KidsBrainIT dataset and their correlations with global outcome at 6 months are determined. The final aim of this study is to improve the treatments of the abnormal physiology insults: increase pressure from brain swelling (raised ICP) and brain perfusion pressure (CPP).

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Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

Clinical Nursing Research ◽

10.1177/10547738211050489 ◽

2021 ◽

pp. 105477382110504

Author(s):

Jeong Eun Yoon ◽

Ok-Hee Cho

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Medical Records ◽

Injury Severity ◽

University Hospital ◽

Factors Associated ◽

Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

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TREATMENT RESULTS EVALUATION IN PATIENTS WITH SEVERE SEPSIS, CAUSED BY SEVERE TRAUMATIC BRAIN INJURY AT INTENSIVE CARE UNIT OF TERNOPIL UNIVERSITY HOSPITAL

Health Problems of Civilization ◽

10.5114/hpc.2016.58201 ◽

2016 ◽

Vol 1 ◽

pp. 5-9

Author(s):

Oleksandr V. Oliynyk ◽

Bohdana O. Pereviznyk ◽

Anna Ślifirczyk ◽

Oleh V. Yemiashev ◽

Nataliya I. Krasiy

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Severe Sepsis ◽

Intensive Care ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

University Hospital ◽

Treatment Results

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Judgments of Critical Care Nurses About Risk for Secondary Brain Injury

American Journal of Critical Care ◽

10.4037/ajcc2009293 ◽

2010 ◽

Vol 19 (3) ◽

pp. 250-260 ◽

Cited By ~ 12

Author(s):

Molly McNett ◽

Margaret Doheny ◽

Carol A. Sedlak ◽

Ruth Ludwick

Keyword(s):

Intensive Care Unit ◽

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Intracranial Pressure ◽

Oxygen Saturation ◽

Cerebral Perfusion ◽

Perfusion Pressure ◽

Secondary Brain Injury ◽

Intensive Care Unit Nurses

Background Interdisciplinary care for patients with traumatic brain injury focuses on treating the primary brain injury and limiting further brain damage from secondary injury. Intensive care unit nurses have an integral role in preventing secondary brain injury; however, little is known about factors that influence nurses’ judgments about risk for secondary brain injury. Objective To investigate which physiological and situational variables influence judgments of intensive care unit nurses about patients’ risk for secondary brain injury, management solely with nursing interventions, and management by consulting another member of the health care team. Methods A multiple segment factorial survey design was used. Vignettes reflecting the complexity of real-life scenarios were randomly generated by using different values of each independent variable. Surveys containing the vignettes were sent to nurses at 2 level I trauma centers. Multiple regression was used to determine which variables influenced judgments about secondary brain injury. Results Judgments about risk for secondary brain injury were influenced by a patient’s oxygen saturation, intracranial pressure, cerebral perfusion pressure, mechanism of injury, and primary diagnosis, as well as by nursing shift. Judgments about interventions were influenced by a patient’s oxygen saturation, intracranial pressure, and cerebral perfusion pressure and by nursing shift. The initial judgments made by nurses were the most significant variable predictive of follow-up judgments. Conclusions Nurses need standardized, evidence-based content for management of secondary brain injury in critically ill patients with traumatic brain injury.

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What is the optimal threshold for cerebral perfusion pressure following traumatic brain injury?

Neurosurgical FOCUS ◽

10.3171/foc.2003.15.6.4 ◽

2003 ◽

Vol 15 (6) ◽

pp. 1-5 ◽

Cited By ~ 24

Author(s):

Paul Vespa

Keyword(s):

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Cerebral Perfusion Pressure ◽

Cerebral Perfusion ◽

Oxygen Supply ◽

Perfusion Pressure ◽

Cerebral Metabolism ◽

Conflicting Evidence ◽

Selection Of

Intensive care of the patient with traumatic brain injury centers on control of intracranial pressure and cerebral perfusion pressure (CPP). The optimal CPP by definition delivers an adequate supply of blood and oxygen to meet the metabolic demands of brain tissue. A great deal of controversy exists regarding the optimal CPP value, with disparate studies providing conflicting evidence for the use of supraphysiological CPP values. No study that accurately assesses the efficacy of normal CPP compared with elevated CPP has been performed, but several studies demonstrate that a CPP threshold exists on an individual basis for patients with TBI. The use of brain monitors of cerebral metabolism and oxygen supply may assist the clinician in the selection of the optimal CPP for an individual patient.

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One-year costs of intensive care in pediatric patients with traumatic brain injury

Journal of Neurosurgery Pediatrics ◽

10.3171/2020.6.peds20189 ◽

2021 ◽

Vol 27 (1) ◽

pp. 79-86

Author(s):

Era D. Mikkonen ◽

Markus B. Skrifvars ◽

Matti Reinikainen ◽

Stepani Bendel ◽

Ruut Laitio ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Intensive Care ◽

Brain Injury ◽

Social Security ◽

Functional Outcome ◽

Injury Severity ◽

Pediatric Population ◽

Favorable Outcome ◽

Index Hospitalization ◽

Pediatric Tbi

OBJECTIVETraumatic brain injury (TBI) is a major cause of death and disability in the pediatric population. The authors assessed 1-year costs of intensive care in pediatric TBI patients.METHODSIn this retrospective multicenter cohort study of four academic ICUs in Finland, the authors used the Finnish Intensive Care Consortium database to identify children aged 0–17 years treated for TBI in ICUs between 2003 and 2013. The authors reviewed all patient health records and head CT scans for admission, treatment, and follow-up data. Patient outcomes included functional outcome (favorable outcome defined as a Glasgow Outcome Scale score of 4–5) and death within 6 months. Costs included those for the index hospitalization, rehabilitation, and social security up to 1 year after injury. To assess costs, the authors calculated the effective cost per favorable outcome (ECPFO).RESULTSIn total, 293 patients were included, of whom 61% had moderate to severe TBI (Glasgow Coma Scale [GCS] score 3–12) and 40% were ≥ 13 years of age. Of all patients, 82% had a favorable outcome and 9% died within 6 months of injury. The mean cost per patient was €48,719 ($54,557) (95% CI €41,326–€56,112). The index hospitalization accounted for 66%, rehabilitation costs for 27%, and social security costs for 7% of total healthcare costs. The ECPFO was €59,727 ($66,884) (95% CI €52,335–€67,120). A higher ECPFO was observed among patients with clinical and treatment-related variables indicative of parenchymal swelling and high intracranial pressure. Lower ECPFO was observed among patients with higher admission GCS scores and those who had epidural hematomas.CONCLUSIONSGreater injury severity increases ECPFO and is associated with higher postdischarge costs in pediatric TBI patients. In this pediatric cohort, over two-thirds of all resources were spent on patients with favorable functional outcome, indicating appropriate resource allocation.

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