Fig. 1.
Fig. 2.
Fig. 3.
Evaluation of the monitoring findings of the patients in the pediatric intensive care unit by days
| PICU admission | Hospitalization Day1 | Hospitalization Day2 | |
|---|---|---|---|
| Mean Arterial Pressure (mmHg) | 82.3 ± 16.8 | 79.6 ± 13.2 | 79.5 ± 10.7 |
| 58–120 | 62–109 | 63–108 | |
| Glasgow Coma Scores | 8.8 ± 2.3 | 9.8 ± 2.3 | 11.0 ± 2.5 |
| 5–13 | 6–14 | 5–14 | |
| Optic Nerve Sheath Diameters (mm) n=24) | 5.8 ± 0.4 | 5.8 ± 0.5 | 5.7 ± 0.5 |
| 4.7–6.7 | 4.6–6.7 | 4.6–7.0 | |
| NIRS (%) | 74.3 ± 11.9 | 74.2 ± 9.9 | 70.4 ± 8.2 |
| 50–91 | 55–95 | 55–89 | |
| Noninvasive ICP (mmHg) | 16.1 ±1.9 | 15.9 ± 2.1 | 15.0 ± 2.5 |
| 11.5–20.6 | 11–21 | 11–21 | |
| Cerebral Perfusion Pressure (mmHg) | 67.8 ± 16.7 | 64.3 ± 11.9 | 63.8 ± 7.8 |
| 40–102 | 46–88 | 50–80 | |
Comparison of prognosis according to neuromonitorization parameters between days
| p value* | GOSE 7-8 (Good prognosis) | GOSE 1-6 (Poor Prognosis) | p value * | |
|---|---|---|---|---|
| Admission NIRS | 75.4±10.0 | 76.6±11.2 | 0.572 | |
| Day 1 NIRS | 0.473 | 73.7±10.4 | 78.0±7.4 | |
| Admission NIRS | 75.4±10.0 | 76.6±11.2 | 0.360 | |
| Day 2 NIRS | 0.009 | 69.7±8.2 | 74.1±8.3 | |
| Day 1 NIRS | 73.7±10.4 | 78.0±7.4 | 0.006 | |
| Day 2 NIRS | 0.003 | 69.7±8.2 | 74.1±8.3 | |
| Admission ONSD | 5.7±0.4 | 6.0±0.4 | 0.203 | |
| Day 1 ONSD | 0.534 | 5.7±0.5 | 6.1±0.4 | |
| Admission ONSD | 5.7±0.4 | 6.0±0.4 | 0.449 | |
| Day 2 ONSD | 0.004 | 5.5±0.4 | 6.1±0.5 | |
| Day 1 ONSD | 5.7±0.5 | 6.1±0.4 | 1.000 | |
| Day 2 ONSD | 0.140 | 5.5±0.4 | 6.1±0.5 | |
| Admission nICP | 15.7±1.8 | 16.7±2.3 | 0.243 | |
| Day 1 nICP | 0.097 | 15.1±1.8 | 17.6±1.7 | |
| Admission nICP | 15.7±1.8 | 16.7±2.3 | 0.729 | |
| Day 2 nICP | <0.001 | 14.0±1.8 | 17.2±2.3 | |
| Day 1 nICP | 15.1±1.8 | 17.6±1.7 | 0.535 | |
| Day 2 nICP | 0.002 | 14.0±1.8 | 17.2±2.3 | |
| Admission CPP | 64.6±14.1 | 74.0±20.6 | 0.240 | |
| Day 1 CPP | 0.987 | 64.7±11.6 | 63.4±13.5 | |
| Admission CPP | 64.6±14.1 | 74.0±20.6 | 0.128 | |
| Day 2 CPP | 0.604 | 62.9±5.7 | 65.6±11.1 | |
| Day 1 CPP | 64.7±11.6 | 63.4±13.5 | 0.687 | |
| Day 2 CPP | 0.481 | 62.9±5.7 | 65.6±11.1 | |
Evaluations of the prognosis according to the follow-up variables according to the days of hospitalization in the pediatric intensive care unit
| Time | Variable | Prognosis | Mean ± SD | p value |
|---|---|---|---|---|
| PICU admission | NIRS | Good(GOSE 7-8) (n=18) | 73.6±10.8 | 0.71 |
| Poor (GOSE 1-6)(n=10) | 75.4±14.1 | |||
| ONSD | Good (GOSE 7-8)(n=16) | 5.7±0.4 | 0.19 | |
| Poor (GOSE 1-6)(n=8) | 5.9±0.5 | |||
| nICP | Good (GOSE 7-8) (n=16) | 15.7±1.8 | 0.23 | |
| Poor (GOSE 1-6) (n=8) | 16.7±2.3 | |||
| CPP | Good (GOSE 7-8) (n=16) | 64.6±14.1 | 0.20 | |
| Poor (GOSE 1-6) (n=8) | 74.0±20.6 | |||
| Hospitalization Day1 | NIRS | Good (GOSE 7-8) | 72.7±10.3 | 0.28 |
| Poor (GOSE 1-6) | 76.9±9.0 | |||
| ONSD | Good (GOSE 7-8) | 5.7±0.5 | 0.01* | |
| Poor (GOSE 1-6) | 6.1±0.4 | |||
| nICP | Good (GOSE 7-8) | 15.1±1.8 | 0.004* | |
| Poor (GOSE 1-6) | 17.6±1.1 | |||
| CPP | Good (GOSE 7-8) | 64.7±11.6 | 0.81 | |
| Poor (GOSE 1-6) | 63.4±13.5 | |||
| Hospitalization Day2 | NIRS | Good (GOSE 7-8) | 69.1±8.0 | 0.29 |
| Poor (GOSE 1-6) | 72.6±8.5 | |||
| ONSD | Good (GOSE 7-8) | 5.5±0.4 | 0.002* | |
| Poor (GOSE 1-6) | 6.1±0.5 | |||
| nICP | Good (GOSE 7-8) | 13.9±1.8 | 0.001* | |
| Poor (GOSE 1-6) | 17.2±2.3 | |||
| CPP | Good (GOSE 7-8) | 62.9±5.7 | 0.43 | |
| Poor (GOSE 1-6) | 65.6±11.1 | |||
Patients' characteristics
| Variable | Value |
|---|---|
| Cause of trauma | |
| Out-of-vehicle traffic accidents | 42.9 % (n=12) |
| Falls from a height | 21.4 % (n=6) |
| Blunt trauma | 17.9 % (n=5) |
| In-vehicle traffic accidents | 14.3 % (n=4) |
| Other reasons | 3.6 % (n=1) |
| The type of traumatic brain injury | |
| Extraparenchymal injuries | 53.6 % (n=15) |
| Intraparenchymal injuries | 35.7% (n=10) |
| Bone fractures | 10.7% (n=3) |
| The treatments | |
| Neurosurgery | 25% (n=7) |
| Antibiotic therapy | 96.4% (n=27) |
| Antiepileptic drugs | 92.9% (n=26) |
| Anti-edema treatment | 96.4% (n=27) |
| Thiopental infusion | 3.6% (n=1) |
| Decompressive craniotomy procedure | 3.6% (n=1) |
| Normothermia | 100% (n=28) |