ArticleCritical care medicine2012
Osmolar therapy in pediatric traumatic brain injury.
Article in Critical care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 42 citations in OpenAlex.
- Variation in intracranial pressure monitoring and outcomes in pediatric traumatic brain injury.Archives of pediatrics & adolescent medicine · 2012Trial
- Should Hypertonic Saline Be Considered for the Treatment of Intracranial Hypertension? A Review of Current Evidence and Clinical Practices.Korean journal of neurotrauma · 2024Review
- Comparison of Intracranial Pressure Measurements Before and After Hypertonic Saline or Mannitol Treatment in Children With Severe Traumatic Brain Injury.JAMA network open · 2022Article
- Computed Tomography Practice Standards for Severe Pediatric Traumatic Brain Injury in the Emergency Department: a National Survey.Journal of child & adolescent trauma · 2021Article
- Accidental trauma of infancy: emergency department evaluation and management.Pediatric emergency medicine practice · 2021Review
- Ability of the PILOT score to predict 6-month functional outcome in pediatric patients with moderate-severe traumatic brain injury.Journal of pediatric surgery · 2020Observational
- Development, implementation, and evaluation of a novel guideline engine for pediatric patients with severe traumatic brain injury: a study protocol.Implementation science communications · 2020Article
- The cost of a pediatric neurocritical care program for traumatic brain injury: a retrospective cohort study.BMC health services research · 2018Article
- Implementation strategies in pediatric neurocritical care.Current opinion in pediatrics · 2017Review
- EEG Monitoring and Antiepileptic Drugs in Children with Severe TBI.Neurocritical care · 2017Article
- Hyperosmolar therapy in pediatric traumatic brain injury: a retrospective study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2016Article
- Intracranial Pressure Monitoring in Infants and Young Children With Traumatic Brain Injury.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2016Observational
- Cervical spine imaging in hospitalized children with traumatic brain injury.Pediatric emergency care · 2015Article
- Pediatric head injury: a pain for the emergency physician?Clinical and experimental emergency medicine · 2015Review
- Pediatric neurotrauma.International journal of critical illness and injury science · 2014Article
- Existing data analysis in pediatric critical care research.Frontiers in pediatrics · 2014Review
- Fluid management in the critically ill child.Pediatric nephrology (Berlin, Germany) · 2014Article
- Initiation of physical, occupational, and speech therapy in children with traumatic brain injury.Archives of physical medicine and rehabilitation · 2013Article
- New trends in hyperosmolar therapy?Current opinion in critical care · 2013Review
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo describe patterns of use for mannitol and hypertonic saline in children with traumatic brain injury, to evaluate any potential associations between hypertonic saline and mannitol use and patient demographic, injury, and treatment hospital characteristics, and to determine whether the 2003 guidelines for severe pediatric traumatic brain injury impacted clinical practice regarding osmolar therapy.
designRetrospective cohort study.
settingPediatric Health Information System database, January, 2001 to December, 2008. PATIENTS: Children (age <18 yrs) with traumatic brain injury and head/neck Abbreviated Injury Scale score ≥ 3 who received mechanical ventilation and intensive care.
interventions: None. MEASUREMENTS AND MAIN
resultsThe primary outcome was hospital billing for parenteral hypertonic saline and mannitol use, by day of service. Overall, 33% (2,069 of 6,238) of the patients received hypertonic saline, and 40% (2,500 of 6,238) received mannitol. Of the 1,854 patients who received hypertonic saline or mannitol for ≥ 2 days in the first week of therapy, 29% did not have intracranial pressure monitoring. After adjustment for hospital-level variation, primary insurance payer, and overall injury severity, use of both drugs was independently associated with older patient age, intracranial hemorrhage (other than epidural), skull fracture, and higher head/neck injury severity. Hypertonic saline use increased and mannitol use decreased with publication of the 2003 guidelines, and these trends continued through 2008.
conclusionsHypertonic saline and mannitol are used less in infants than in older children. The patient-level and hospital-level variation in osmolar therapy use and the substantial amount of sustained osmolar therapy without intracranial pressure monitoring suggest opportunities to improve the quality of pediatric traumatic brain injury care. With limited high-quality evidence available, published expert guidelines appear to significantly impact clinical practice in this area.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.