TY  - JOUR
PY  - 2020//
TI  - Intracranial pressure monitoring associated with increased mortality in pediatric brain injuries
JO  - Pediatric surgery international
A1  - Delaplain, Patrick T.
A1  - Grigorian, Areg
A1  - Lekawa, Michael
A1  - Mallicote, Michael
A1  - Joe, Victor
A1  - Schubl, Sebastian D.
A1  - Kuza, Catherine M.
A1  - Dolich, Matthew
A1  - Nahmias, Jeffry
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Utilization of ICP monitors for pediatric patients is low and varies between centers. We hypothesized that in more severely injured patients (GCS 3-4), there would be a decreased mortality associated with invasive monitoring devices. <br><br>METHODS: The pediatric Trauma Quality Improvement Program (TQIP) was queried for patients aged ≤ 16 years meeting criteria for invasive monitors. Our primary outcome was mortality. Patients with ICP monitoring were compared to those without. A logistic regression was used to examine the risk of mortality. <br><br>RESULTS: Of 3,808 patients, 685 (18.0%) underwent ICP monitoring. ICP monitors were associated with increased risk of mortality (OR 1.82, CI 1.36-2.44, p < 0.001). A secondary analysis including type of invasive ICP monitor and dividing GCS into 3 categories revealed both intraventricular drain (OR 1.89, CI 1.3-2.7, p = 0.001) and intraparenchymal pressure monitor (OR 1.86, CI 1.32-2.6, p < 0.001) to be independently associated with an increased likelihood of mortality regardless of GCS, while intraparenchymal oxygen monitoring was not (OR 0.47, CI 0.11-2.05, p = 0.316). The strongest effect was seen in those patients with a GCS of 5-6. <br><br>CONCLUSION: ICP monitors are an independent risk factor for mortality, particularly with intraventricular drains and intraparenchymal monitors in patients with a GCS 5-6.<p />  <p>Language: en</p>
LA  - en
SN  - 0179-0358
UR  - http://dx.doi.org/10.1007/s00383-020-04618-y
ID  - ref1
ER  -