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Age-related differences in intracranial pressure and cerebral perfusion pressure in the first 6 hours of monitoring after children's head injury: Association with outcome

Age-related differences in intracranial pressure and cerebral perfusion pressure in the first 6 hours of monitoring after children's head injury: Association with outcome
Age-related differences in intracranial pressure and cerebral perfusion pressure in the first 6 hours of monitoring after children's head injury: Association with outcome

Objectives: Severe head injury in childhood is associated with considerable mortality and morbidity. In this study we determined age-related differences in the relationship between outcome and intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in the first 6 h of monitoring in a large cohort of head-injured children. Methods: Two hundred and thirty-five head-injured children (admitted to five UK hospitals over a 15-year period) in whom intracranial pressure monitoring was clinically indicated were studied. Results: Patients were divided into three age groups (2 - 6, 7 - 10 and 11 - 16 years). The sensitivity of ICP and CPP were similar. Differences were found in the specificity of ICP and CPP for each group and these were more marked for CPP. For a specificity of 50% the pressures were 53, 63 and 66 mmHg for the three age groups. Conclusions: There are age-related differences in the specificity of intracranial pressure and cerebral perfusion pressure in relation to outcome. These differences may be important in the clinical management of head-injured children. Thus cerebral perfusion pressures of 53, 63 and 66 mmHg should be the minimum to strive for in these three age groups respectively.

Age, Children, Intracranial hypertension, Intracranial monitoring, Sensitivity, Specificity, Thresholds, Traumatic coma
0256-7040
195-199
Chambers, I. R.
0cfe440f-2bd3-411f-bb22-fce441fdf111
Stobbart, L.
514132c6-bd09-4891-8b38-fd5864b3527d
Jones, P. A.
d88b8e7c-e122-4231-80bb-4135e235cd41
Kirkham, F. J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Marsh, M.
993ee686-f303-4994-9f49-14ae3fbdcc42
Mendelow, A. D.
0f347ad6-5745-48a9-9b2b-c84bb105eaf9
Minns, R. A.
2cda9f73-1a86-4480-a6ec-9165c8bba0ed
Struthers, S.
af52bc0d-a7fc-4af2-9970-9193b9e04de7
Tasker, R. C.
650dc1a0-35f7-4c93-ac05-909c95a17b68
Chambers, I. R.
0cfe440f-2bd3-411f-bb22-fce441fdf111
Stobbart, L.
514132c6-bd09-4891-8b38-fd5864b3527d
Jones, P. A.
d88b8e7c-e122-4231-80bb-4135e235cd41
Kirkham, F. J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Marsh, M.
993ee686-f303-4994-9f49-14ae3fbdcc42
Mendelow, A. D.
0f347ad6-5745-48a9-9b2b-c84bb105eaf9
Minns, R. A.
2cda9f73-1a86-4480-a6ec-9165c8bba0ed
Struthers, S.
af52bc0d-a7fc-4af2-9970-9193b9e04de7
Tasker, R. C.
650dc1a0-35f7-4c93-ac05-909c95a17b68

Chambers, I. R., Stobbart, L., Jones, P. A., Kirkham, F. J., Marsh, M., Mendelow, A. D., Minns, R. A., Struthers, S. and Tasker, R. C. (2005) Age-related differences in intracranial pressure and cerebral perfusion pressure in the first 6 hours of monitoring after children's head injury: Association with outcome. Child's Nervous System, 21 (3), 195-199. (doi:10.1007/s00381-004-1060-x).

Record type: Article

Abstract

Objectives: Severe head injury in childhood is associated with considerable mortality and morbidity. In this study we determined age-related differences in the relationship between outcome and intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in the first 6 h of monitoring in a large cohort of head-injured children. Methods: Two hundred and thirty-five head-injured children (admitted to five UK hospitals over a 15-year period) in whom intracranial pressure monitoring was clinically indicated were studied. Results: Patients were divided into three age groups (2 - 6, 7 - 10 and 11 - 16 years). The sensitivity of ICP and CPP were similar. Differences were found in the specificity of ICP and CPP for each group and these were more marked for CPP. For a specificity of 50% the pressures were 53, 63 and 66 mmHg for the three age groups. Conclusions: There are age-related differences in the specificity of intracranial pressure and cerebral perfusion pressure in relation to outcome. These differences may be important in the clinical management of head-injured children. Thus cerebral perfusion pressures of 53, 63 and 66 mmHg should be the minimum to strive for in these three age groups respectively.

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Published date: March 2005
Keywords: Age, Children, Intracranial hypertension, Intracranial monitoring, Sensitivity, Specificity, Thresholds, Traumatic coma

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Local EPrints ID: 428154
URI: https://eprints.soton.ac.uk/id/eprint/428154
ISSN: 0256-7040
PURE UUID: 960fd263-cef7-431f-ba2b-1eb7d720478f

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Date deposited: 13 Feb 2019 17:30
Last modified: 13 Feb 2019 17:30

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Contributors

Author: I. R. Chambers
Author: L. Stobbart
Author: P. A. Jones
Author: F. J. Kirkham
Author: M. Marsh
Author: A. D. Mendelow
Author: R. A. Minns
Author: S. Struthers
Author: R. C. Tasker

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