Evidence map›Paper›PMID 25599147›Full record

ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2015

Effect of administration of neuromuscular blocking agents in children with severe traumatic brain injury on acute complication rates and outcomes: a secondary analysis from a randomized, controlled trial of therapeutic hypothermia.

Katherine H Chin, Michael J Bell, Stephen R Wisniewski, Goundappa K Balasubramani, Patrick M Kochanek, Sue R Beers, S Danielle Brown, P David Adelson, Pediatric Traumatic Brain Injury Consortium: Hypothermia Investigators

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 15 citations in OpenAlex.

  1. Observational
  2. Approaches to neuroprotection in pediatric neurocritical care.World journal of critical care medicine · 2023
    Review
  3. Review
  4. Article
  5. Neuroprotective measures in children with traumatic brain injury.World journal of critical care medicine · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Katherine H Chin1Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA. 2Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA. 3Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 4Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA. 5Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA. 6Barrow Neurological Institute of Phoenix Children's Hospital, Phoenix, AZ.
Michael J Bell
Stephen R Wisniewski
Goundappa K Balasubramani
Patrick M Kochanek
Sue R Beers
S Danielle Brown
P David Adelson
Pediatric Traumatic Brain Injury Consortium: Hypothermia Investigators
University of Pittsburgh · USBarrow Neurological Institute · USNeurological Surgery · USPhoenix Children's Hospital · US

Funding

Multiple Medical Therapies for Pediatric TBI; Comparative Effectiveness ApproachU01NS081041 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BELL, MICHAEL J, WISNIEWSKI, STEPHEN R · 2013 to 2017
$15.9M
Pediatric Traumatic Brain Injury Consortium: HypothermiaU01NS052478 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ADELSON, P. DAVID · 2007 to 2011
$6.7M
Familial Pathways to Early-Onset Suicide AttemptsR01MH056612 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BRENT, DAVID A. · 2002 to 2013
$5.4M
Psychiatric outcomes of children at high- and low-risk for depression: follow upR01MH085722 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KOVACS, MARIA · 2010 to 2014
$3.3M
Implementation Science to Increase Use of Evidence Based Pediatric Brain Injury GR01NS072308 · NINDS · UNIVERSITY OF WASHINGTON · PI VAVILALA, MONICA S · 2010 to 2014
$2.6M
Overcoming Membrane Transporters to Improve CNS Drug TherapyR01NS069247 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CLARK, ROBERT S B · 2009 to 2013
$2.2M
Polynitroxylated Pegylated Hemoglobin for Traumatic Brian Injury ResuscitationU44NS070324 · NINDS · SYNZYME TECHNOLOGY, INC. · PI HSIA, CARLETON · 2011 to 2016
$1.6M
FAMILIAL PATHWAYS TO EARLY-ONSET SUICIDE ATTEMPTSR10MH056612 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BRENT, DAVID A. · 1997 to 2001
$824k
A DEVELOPMENTAL EXAMINATION OF CHILDREN'S MAP USE SKILLSF32HD008003 · NICHD · HARVARD UNIVERSITY · PI SANDBERG, ELISABETH HOLLISTER · 1996 to 1998
–
NICHD NIH HHS F32 HD008003NICHD NIH HHS HD0499893NICHD NIH HHS HD08003NIMH NIH HHS MH085722NIMH NIH HHS MH56612NIMH NIH HHS R01 MH056612NIMH NIH HHS R01 MH085722NIMH NIH HHS R10 MH056612NINDS NIH HHS NS052478NINDS NIH HHS NS069247NINDS NIH HHS NS070324NINDS NIH HHS NS081041NINDS NIH HHS R01 NS069247NINDS NIH HHS R01 NS072308NINDS NIH HHS U01 NS052478NINDS NIH HHS U01 NS081041NINDS NIH HHS U44 NS070324
6 · The paper itself

Abstract

objectiveTo evaluate the association between neuromuscular blocking agents and outcome, intracranial pressure, and medical complications in children with severe traumatic brain injury.

designA secondary analysis of a randomized, controlled trial of therapeutic hypothermia.

settingSeventeen hospitals in the United States, Australia, and New Zealand. PATIENTS: Children (< 18 yr) with severe traumatic brain injury.

interventionsNone for this secondary analysis. MEASUREMENTS AND MAIN

resultsChildren received neuromuscular blocking agent on the majority of days of the study (69.6%), and the modified Pediatric Intensity Level of Therapy scores (modified by removing neuromuscular blocking agent administration from the score) were increased on days when neuromuscular blocking agents were used (9.67 ± 0.21 vs 5.48 ± 0.26; p < 0.001). Children were stratified into groups based on exposure to neuromuscular blocking agents (group 1 received neuromuscular blocking agents each study day; group 2 did not). Group 1 had increased number of daily intracranial pressure readings more than 20 mm Hg (4.4 ± 1.1 vs 2.4 ± 0.5;p = 0.015) and longer ICU and hospital length of stay (p = 0.003 and 0.07, respectively, Kaplan-Meier). The Glasgow Outcome Score-Extended for Pediatrics at hospital discharge and 3, 6, and 12 months after traumatic brain injury and medical complications observed during the acute hospitalization were similar between groups.

conclusionsAdministration of neuromuscular blocking agents was ubiquitous and daily administration of neuromuscular blocking agents was associated with intracranial hypertension but not outcomes-likely indicating that increased injury severity prompted their use. Despite this, neuromuscular blocking agent use was not associated with complications. A different study design-perhaps using randomization or methodologies-of a larger cohort will be required to determine if neuromuscular blocking agent use is helpful after severe traumatic brain injury in children.

Indexed as

AdolescentAustraliaBrain InjuriesChildChild, PreschoolDose-Response Relationship, DrugFemaleGlasgow Coma ScaleHumansHypothermia, InducedInfantInjury Severity ScoreIntracranial HypertensionIntracranial PressureLength of StayMaleNeuromuscular Blocking Agents

Identifiers

PMID25599147
PMCPMC4424136
OpenAlexW2323202397

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

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.