Perioperative management of the pediatric patient with traumatic brain injury

Tarun Bhalla*, Elisabeth Dewhirst, Amod Sawardekar, Olamide Dairo, Joseph D. Tobias

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

Summary TBI and its sequelae remain a major healthcare issue throughout the world. With an improved understanding of the pathophysiology of TBI, refinements of monitoring technology, and ongoing research to determine optimal care, the prognosis of TBI continues to improve. In 2003, the Society of Critical Care Medicine published guidelines for the acute management of severe TBI in infants, children, and adolescents. As pediatric anesthesiologists are frequently involved in the perioperative management of such patients including their stabilization in the emergency department, familiarity with these guidelines is necessary to limit preventable secondary damage related to physiologic disturbances. This manuscript reviews the current evidence-based medicine regarding the care of pediatric patients with TBI as it relates to the perioperative care of such patients. The issues reviewed include those related to initial stabilization, airway management, intra-operative mechanical ventilation, hemodynamic support, administration of blood and blood products, positioning, and choice of anesthetic technique. The literature is reviewed regarding fluid management, glucose control, hyperosmolar therapy, therapeutic hypothermia, and corticosteroids. Whenever possible, management recommendations are provided.

Original languageEnglish (US)
Pages (from-to)627-640
Number of pages14
JournalPaediatric anaesthesia
Volume22
Issue number7
DOIs
StatePublished - Jul 1 2012

Keywords

  • adolescent
  • age
  • audit
  • child
  • general anesthesia
  • neuroanesthesia
  • neurosurgery
  • trauma
  • traumatic brain injury

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Anesthesiology and Pain Medicine

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