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J Pediatr Surg. 1998 Feb;33(2):333-8.

Early hypotension worsens neurological outcome in pediatric patients with moderately severe head trauma.

Author information

1
Department of Surgery, St Louis University Health Sciences Center and Cardinal Glennon Children's Hospital, Missouri 63104, USA.

Abstract

PURPOSE:

The objective of this study was to determine the morbidity associated with hypotension in the resuscitative phase of pediatric head trauma.

METHODS:

A retrospective review (1990 to 1995) was performed at a level-1 pediatric trauma facility. Inclusion criteria included a Glasgow coma score (GCS) of 6 to 8 and absence of penetrating trauma or bleeding disorders. The GCS was assigned using a postresuscitation examination by a neurosurgeon. Hypotension was defined as a blood pressure reading of less than the fifth percentile for age that lasted longer than 5 minutes. Episodes were monitored from the onset of injury through the first 24 hours of hospitalization. Glasgow outcome scale (GOS) was assigned based on a 3-month follow-up evaluation. Analysis of variance (ANOVA) and contingency table analysis were performed on all groups, and a P value of less than .05 was taken to represent statistical significance.

RESULTS:

Seventy-two patients met inclusion criteria. They had a mean GCS of 7.2 and a mean age of 6 years; 97% survived. Early hypotension was associated with worse neurological outcome (GOS) and prolonged hospitalization. There was no significant correlation between GOS and age, gender, injury mechanism, associated injuries, or transport time.

CONCLUSIONS:

These data suggest that maintaining adequate blood pressure during the early resuscitation of pediatric blunt head trauma patients may improve neurological outcome.

PMID:
9498412
[Indexed for MEDLINE]

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