In the United States, there are more than 600,000 children each year seen in emergency rooms due to traumatic brain injury (TBI), a disruption to the normal function of the brain caused by a bump, blow or jolt to the head. Severe TBI results in approximately 7,000 childhood deaths annually, while survivors of the condition may suffer from long-term health conditions such as seizures, learning difficulty and communication disorders.

Karin Reuter-Rice, PhD, CPNP-AC, FCCM, FAAN, associate professor, focuses her research in the area of trauma and head injury. She examines genomic influences and physiologic changes such as cerebral blood flow and immune system responses that can impact neurocognitive outcomes in pediatric patients admitted to the hospital with a TBI.

Promoting the highest standards of care and improving the overall rates of survival and recovery following a TBI, a panel of pediatric critical care, neurosurgery and other pediatric experts including Reuter-Rice issued the 3^rd edition of the Brain Trauma Foundation Guidelines for the Management of Pediatric Severe TBI.

The updated guidelines reflect the addition of nearly 50 research studies and include eight new, or revised, treatment recommendations for healthcare providers that range from the use of intracranial monitoring to the use of hypertonic saline to reduce acute brain swelling.

“These guidelines provide the most current scientific evidence in the care and treatment of children who present with a serious brain injury,” said Reuter-Rice. “The updated guidelines, executive summary, and treatment algorithms were developed to assist healthcare providers internationally in their approach to care for children with severe TBI. These new recommendations will help save lives and improve health outcomes in children with severe TBI.”

An executive summary of the guidelines published in the journals of Pediatric Critical Care Medicine, an official journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

An associated manuscript, also published in Pediatric Critical Care Medicine, describes an algorithm designed to guide first and second tier therapies for infants and children with severe TBI. The tool for bedside use by caregivers, which supplements evidence-based recommendations in the updated guidelines, was created using a validated, consensus-based expert opinion process.

“We believe a combination of research findings and real-life experience will further advance the bedside care of infants and children with severe TBI, especially in treatment scenarios where scientific and clinical research is lacking,” said first author Patrick Kochanek, MD, Grenvik professor and vice chairman of Critical Care Medicine and director of the Safar Center for Resuscitation Research at the University of Pittsburgh. “This algorithm will also help to identify key research priorities to help ensure ongoing momentum of consistent, high-quality care for patients across the globe.” 

The original Brain Trauma Foundation Guidelines published in 2003 and were last updated in 2012. The 3rd edition was developed as part of the Brain Trauma Evidence-based Consortium based at the Stanford University School of Medicine. The Pacific Northwest Evidence-based Practice Center at OHSU managed the effort, which included experts from OHSU, the University of Pittsburgh, Boston Children’s Hospital, Phoenix Children’s Hospital, Children’s National Medical Center, Seattle Children’s Hospital, the University of Utah, the University of British Columbia, and Duke University.

Join us as we celebrate brain injury awareness month and raise awareness for traumatic brain injury. While traumatic brain injuries may not be preventable, it’s possible to improve the support and resources available to those who need it. Learn more about the resources available here.