Challenges and opportunities for pediatric severe TBI-review of the evidence and exploring a way forward

被引:30
作者
Bell, Michael J. [1 ]
Adelson, P. David [2 ,3 ]
Wisniewski, Stephen R. [4 ]
机构
[1] Childrens Natl Med Ctr, Dept Pediat & Crit Care Med, 111 Michigan Ave NW, Washington, DC 20010 USA
[2] Phoenix Childrens Hosp, Dept Neurol Surg, Phoenix, AZ USA
[3] Phoenix Childrens Hosp, Barrow Neurol Inst, Phoenix, AZ USA
[4] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA
基金
美国国家卫生研究院;
关键词
Children; Pediatric neurotrauma; Severe traumatic brain injury; Pediatric neurocritical care; Comparative effectiveness research; Evidenced-based guidelines; TRAUMATIC BRAIN-INJURY; RANDOMIZED CONTROLLED-TRIAL; SEVERE HEAD-INJURY; UNITED-STATES; DEXAMETHASONE THERAPY; HYPERTONIC SALINE; CHILDREN; HYPOTHERMIA; COSTS;
D O I
10.1007/s00381-017-3530-y
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Traumatic brain injury (TBI) is a leading killer of children in the developed and developing world. Despite evidence-based guidelines and several recent clinical trials, the progress in developing best practices for children with severe TBI has been slow. This article describes (i) the burden of the disease, (ii) the inadequacies of the evidence-based guidelines, (iii) the failure of the largest clinical trials to prove their primary hypotheses, and (iv) possible advances from an observational cohort study called the Approaches and Decisions for Acute Pediatric TBI (ADAPT) Trial that has recently completed enrollment.
引用
收藏
页码:1663 / 1667
页数:5
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