Traumatic Bain Injuries in Children

Introduction & The main purpose of this review is to discuss the latest recommendations and strategies for treatment of pediatric patients with traumatic brain injury (TBI).
Through this review, 45 eligible and relevant studies were chosen and the level of evidence was evaluated. The statements which are discussed as “recommendations” refer to class II level of evidence, while the ones which are brought as “options” refer to class III.
In pediatric patients with TBI, CPP should be kept above 40mmHg. Bolus infusion of mannitol (0.25- 1g/kg) or continuous infusion of hypertonic (3%) saline (0.1-1 ml/kg) are useful methods to reduce ICP. It is recommended to use minimum doses to decrease ICP to 20mmHg. Administration of steroids suppress endogen cortisol secretion and increase complications like infection. Long-term prophylactic hyperventilation, even mild, should be avoided.
Undoubtedly, nothing is more effective than proper prophylaxis. The main duty of a physician in confronting TBI is to reduce secondary injuries caused by hypoxia, hypotension, elevated ICP, reduced CPP, cerebral ischemia, etc.