Karin Reuter-Rice is an associate professor, Duke University School of Nursing, Duke University School of Medicine Department of Pediatrics, and Duke Institute for Brain Sciences, Durham, North Carolina.
Elise Christoferson is an accelerated BSN student at Duke University School of Nursing.
Am J Crit Care. 2020 Jan 1;29(1):e13-e18. doi: 10.4037/ajcc2020228.
Severe traumatic brain injury (TBI) is associated with high rates of death and disability. As a result, the revised guidelines for the management of pediatric severe TBI address some of the previous gaps in pediatric TBI evidence and management strategies targeted to promote overall health outcomes.
To provide highlights of the most important updates featured in the third edition of the guidelines for the management of pediatric severe TBI. These highlights can help critical care providers apply the most current and appropriate therapies for children with severe TBI.
After a brief overview of the process behind identifying the evidence to support the third edition guidelines, both relevant and new recommendations from the guidelines are outlined to provide critical care providers with the most current management approaches needed for children with severe TBI. Recommendations for neuroimaging, hyperosmolar therapy, analgesics and sedatives, seizure prophylaxis, ventilation therapies, temperature control/hypothermia, nutrition, and corticosteroids are provided. In addition, the complete guideline document and its accompanying algorithm for recommended therapies are available electronically and are referenced within this article.
The evidence base for treating pediatric TBI is increasing and provides the basis for high-quality care. This article provides critical care providers with a quick reference to the current evidence when caring for a child with a severe TBI. In addition, it provides direct access links to the comprehensive guideline document and algorithms developed to support critical care providers.
严重创伤性脑损伤（TBI）的死亡率和致残率较高。因此，修订后的小儿严重 TBI 管理指南解决了小儿 TBI 证据和管理策略方面的一些先前差距，这些策略旨在促进整体健康结果。
提供小儿严重 TBI 管理指南第三版中最重要更新的要点。这些要点可以帮助重症监护提供者为严重 TBI 患儿应用最新和最合适的治疗方法。
在简要概述确定支持第三版指南的证据的过程之后，从指南中概述了相关和新的建议，为重症监护提供者提供了严重 TBI 患儿所需的最新管理方法。提供了神经影像学、高渗治疗、镇痛和镇静、癫痫预防、通气治疗、体温控制/低温、营养和皮质类固醇的建议。此外，完整的指南文件及其推荐治疗方法的配套算法均可在线获得，并在本文中引用。
治疗小儿 TBI 的证据基础正在增加，为高质量的护理提供了依据。本文为重症监护提供者在照顾严重 TBI 患儿时提供了快速参考当前证据的方法。此外，它还提供了直接访问综合指南文件和算法的链接，以支持重症监护提供者。
