Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool Kids): a phase 3, randomised controlled trial On the basis of mixed results from previous trials, we assessed whether therapeutic hypothermia for 48-72 h with slow rewarming improved mortality in children after brain injury.In this phase 3, multicenter, multinational, randomised controlled trial, we included patients with severe traumatic brain injury who were younger than 18 years and could (...) of adverse events or serious adverse events.Hypothermia for 48 h with slow rewarming does not reduce mortality of improve global functional outcome after paediatric severe traumatic brain injury.National Institute of Neurological Disorders and Stroke and National Institutes of Health.Copyright © 2013 Elsevier Ltd. All rights reserved.

A prospective, randomized Phase II clinical trial to evaluate the effect of combined hyperbaric and normobaric hyperoxia on cerebral metabolism, intracranial pressure, oxygen toxicity, and clinical outcome in severe traumatic brain injury Preclinical and clinical investigations indicate that the positive effect of hyperbaric oxygen (HBO2) for severe traumatic brain injury (TBI) occurs after rather than during treatment. The brain appears better able to use baseline O2 levels following HBO2 (...) treatments. In this study, the authors evaluate the combination of HBO2 and normobaric hyperoxia (NBH) as a single treatment.Forty-two patients who sustained severe TBI (mean Glasgow Coma Scale [GCS] score 5.7) were prospectively randomized within 24 hours of injury to either: 1) combined HBO2/NBH (60 minutes of HBO2 at 1.5 atmospheres absolute [ATA] followed by NBH, 3 hours of 100% fraction of inspired oxygen [FiO2] at 1.0 ATA) or 2) control, standard care. Treatments occurred once every 24 hours for 3

Interventions provided in the acute phase for mild traumatic brain injury: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

Incidence, prevalence, and occurrence rate of infection among adults hospitalized after traumatic brain injury: study protocol for a systematic review and meta-analysis. Infection occurs commonly among patients hospitalized after traumatic brain injury (TBI) and has been associated with increased intensive care unit and hospital lengths of stay and an elevated risk of poor neurological outcome and mortality. However, as many relevant published studies to date have varied in the type

Interventions provided in the acute phase for mild traumatic brain injury: a systematic review. Most patients who sustain mild traumatic brain injury (mTBI) have persistent symptoms at 1 week and 1 month after injury. This systematic review investigated the effectiveness of interventions initiated in acute settings for patients who experience mTBI.We performed a systematic review of all randomized clinical trials evaluating any intervention initiated in an acute setting for patients

Mannitol for acute traumatic brain injury. Mannitol is sometimes effective in reversing acute brain swelling, but its effectiveness in the ongoing management of severe head injury remains unclear. There is evidence that, in prolonged dosage, mannitol may pass from the blood into the brain, where it might cause increased intracranial pressure.To assess the effects of different mannitol therapy regimens, of mannitol compared to other intracranial pressure (ICP) lowering agents, and to quantify (...) the effectiveness of mannitol administration given at other stages following acute traumatic brain injury.We searched the Cochrane Injuries Group Specialised Register, CENTRAL (The Cochrane Library), MEDLINE (OvidSP), EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED & CPCI-S) and PubMed. We checked reference lists of trials and review articles, and contacted authors of trials. The search was updated on the 20th April 2009.Randomised controlled trials of mannitol, in patients with acute traumatic brain injury

Effect of rehabilitation length of stay on outcomes in individuals with traumatic brain injury or spinal cord injury: a systematic review protocol. Rehabilitation interventions are a key component of the services required by individuals with neurotrauma to recover or compensate for altered abilities and achieve optimal social participation. Primary studies have produced evidence of the effect of rehabilitation length of stay on individuals with neurotrauma. However, to date no systematic review

Fatigue in adults with traumatic brain injury: predictors and consequences. A systematic review of longitudinal study protocols. Despite strong indications that fatigue is the most common and debilitating symptom after traumatic brain injury, little is known about its frequency, natural history, or relation to other factors. The current protocol outlines a strategy for a systematic review that will identify, assess, and critically appraise studies that assessed predictors for fatigue (...) and the consequences of fatigue on at least two separate time points following traumatic brain injury.MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, CINAHL, and PsycINFO will be systematically searched for relevant peer-reviewed studies. Reference lists of eligible papers will also be searched. All English language studies with a longitudinal design that focus on fatigue in adults with primary-impact traumatic brain injury will be included. Studies on fatigue following brain injury due to secondary

A Trial of Intracranial-Pressure Monitoring in Traumatic Brain Injury PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

Disparities in Disability After Traumatic Brain Injury Among Hispanic Children and Adolescents To compare the extent of disability in multiple areas of functioning after mild, moderate, and severe traumatic brain injury (TBI) between Hispanic and non-Hispanic white (NHW) children.This was a prospective cohort study of children aged <18 years treated for a TBI between March 1, 2007, and September 30, 2008. Hispanic (n = 74) and NHW (n = 457) children were included in the study. Outcome measures (...) were disability in health-related quality of life, adaptive skills, and participation in activities 3, 12, 24, and 36 months after injury compared with preinjury functioning. We compared change in outcome scores between Hispanic and NHW children at each follow-up time. All analyses were adjusted for age, gender, severity and intent of injury, insurance, family function at baseline, parental education, and income.The health-related quality of life for all children was lower at all follow-up times

Participation after Multidisciplinary Rehabilitation for Moderate to Severe Traumatic Brain Injury in Adults: A Systematic Review To determine the effectiveness and comparative effectiveness of multidisciplinary rehabilitation programs for moderate to severe traumatic brain injury (TBI) in improving participation-related outcomes in adults. This article presents results of select key questions from a recent Agency for Healthcare Quality and Research comparative effectiveness review.MEDLINE

Predictive value of S-100β protein for prognosis in patients with moderate and severe traumatic brain injury: systematic review and meta-analysis. To determine the ability and accuracy of the S-100β protein in predicting prognosis after a moderate or severe traumatic brain injury.Systematic review and meta-analysis of randomised controlled trials and observational studies.Medline, Embase, Cochrane Central Register of Controlled Trials, BIOSIS (from their inception to April 2012), conference (...) abstracts, bibliographies of eligible articles, and relevant narrative reviews.Two reviewers independently reviewed citations and selected eligible studies, defined as cohort studies or randomised control trials including patients with moderate or severe traumatic brain injury and evaluating the prognostic value of S-100β protein. Outcomes evaluated were mortality, score on the Glasgow outcome scale, or brain death.Two independent reviewers extracted data using a standardised form and evaluated

Complications of Mild Traumatic Brain Injury in Veterans and Military Personnel Management Briefs Enter search terms Button to search HSRD ® Inside VA Budget and Performance Inside the News Room National Observances Special Events » » » » » Management Briefs Health Services Research & Development Management Briefs Management eBriefs: Provide VA senior managers with results from VA Health Services Research in a concise and timely manner. , April 2019, Issue 152 , March 2019, Issue 151 , March

Cognitive function and other risk factors for mild traumatic brain injury in young men: nationwide cohort study. To investigate cognitive function and other risk factors for mild traumatic brain injury in young men.Nationwide prospective cohort study.Sweden.305 885 men conscripted for military service from 1989 to 1994.mild traumatic brain injuries in relation to cognitive function and other potential risk factors assessed at conscription and follow-up.Men with one mild traumatic brain injury (...) within two years before (n=1988) or after cognitive testing (n=2214) had about 5.5% lower overall cognitive function scores than did men with no mild traumatic brain injury during follow up (P<0.001 for both). Moreover, men with at least two mild traumatic brain injuries after cognitive testing (n=795) had 15% lower overall cognitive function scores compared with those with no such injury (P<0.001). Independent strong risk factors (P<1×10(-10)) for at least one mild traumatic brain injury after

Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences.A prospective cross-sectional cohort study.Level I trauma center.Adults (N=242) with TBI of various severity.Not applicable.Extended Glasgow Outcome Scale, return to work (...) (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale.In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P<.05

Protocol management of severe traumatic brain injury in intensive care units: a systematic review Protocol management of severe traumatic brain injury in intensive care units: a systematic review Protocol management of severe traumatic brain injury in intensive care units: a systematic review English SW, Turgeon AF, Owen E, Doucette S, Pagliarello G, McIntyre L CRD summary The review concluded that management protocols (or care pathways) for severe traumatic brain injury were associated (...) with reductions in death rate and improved neurologic outcome, although no definitive conclusions about efficacy can be made due to limitations of the included studies. These conclusions were suitably cautious in reflecting the limited evidence available, and the recommendations for further research were appropriate. Authors' objectives To compare the use of management protocols (or care pathways) versus usual care for adult intensive care unit patients with acute severe traumatic brain injury. Searching Ten

BHR-100 for severe traumatic brain injury ? first line BHR-100 for severe traumatic brain injury – first line BHR-100 for severe traumatic brain injury – first line NIHR HSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation NIHR HSC. BHR-100 for severe traumatic brain injury – first line. Birmingham: NIHR Horizon Scanning Centre (NIHR HSC (...) ). Horizon Scanning Review. 2013 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Brain Injuries; Progesterones Language Published English Country of organisation England English summary An English language summary is available. Address for correspondence The NIHR Horizon Scanning Centre, Department of Public Health, Epidemiology, and Biostatistics, School of Health&Population Sciences, University of Birmingham, 90 Vincent Drive, Edgbaston, Birmingham, B15 2SP. United Kingdom

Reliable Change in Postconcussive Symptoms and Its Functional Consequences Among Children With Mild Traumatic Brain Injury OBJECTIVE To examine reliable change in postconcussive symptoms and its functional consequences among children with mild traumatic brain injury (TBI) over the first year postinjury as compared with children with orthopedic injuries. DESIGN Prospective, longitudinal cohort. SETTING Emergency departments at 2 children's hospitals. PARTICIPANTS Eight- to 15-year-old children (...) with mild TBI (n = 186) or orthopedic injuries (n = 99). MAIN EXPOSURE Closed-head or orthopedic trauma. MAIN OUTCOME MEASURES Parents rated preinjury symptoms retrospectively shortly after injury and postconcussive symptoms at 2 weeks and 3 and 12 months postinjury. A regression-based approach was used to determine whether each child displayed reliable increases in postconcussive symptoms at each postinjury occasion. Health-related quality of life was assessed at 3 and 12 months postinjury. Information

A cost-minimization analysis of phenytoin versus levetiracetam for early seizure pharmacoprophylaxis after traumatic brain injury A cost-minimization analysis of phenytoin versus levetiracetam for early seizure pharmacoprophylaxis after traumatic brain injury A cost-minimization analysis of phenytoin versus levetiracetam for early seizure pharmacoprophylaxis after traumatic brain injury Pieracci FM, Moore EE, Beauchamp K, Tebockhorst S, Barnett CC, Bensard DD, Burlew CC, Biffl WL, Stoval RT (...) , Johnson JL Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the clinical and economic impact of levetiracetam, compared with phenytoin, to prevent early seizures after traumatic brain injury. The authors concluded

Hyperbaric oxygen therapy for the adjunctive treatment of traumatic brain injury. Traumatic brain injury is a common health problem with significant effect on quality of life. Each year in the USA approximately 0.56% of the population suffer a head injury, with a case fatality rate of about 40% for severe injuries. These account for a high proportion of deaths in young adults. In the USA, 2% of the population live with long-term disabilities following head injuries. The major causes are motor (...) these two trials showed considerable heterogeneity (I(2) = 83%). Two studies reported an incidence of 13% for significant pulmonary impairment in the HBOT group versus 0% in the non-HBOT group (P = 0.007).In general, the studies were small and carried a significant risk of bias. None described adequate randomisation procedures or allocation concealment, and none of the patients or treating staff were blinded to treatment.In people with traumatic brain injury, while the addition of HBOT may reduce