[Monitoring intracranial pressure in severe traumatic brain injury].
BACKGROUND
Severe traumatic brain injury (TBI) is a serious condition. Intracranial pressure (ICP) monitoring can be used to direct treatment, which is of limited access in developing countries.


OBJECTIVE
To describe the clinical experience of pediatric patients with severe TBI.


METHODS
A clinical experience in patients with severe TBI was conducted. Age was 1-17 years, exclusion criteria were chronic illness and psicomotor retardation. Informed consent was obtained in each case. Two groups were formed based on the criterion of neurosurgeons: with and without intracraneal pressure (ICP) monitoring. PIC monitoring was performed through a 3PN Spiegelberg catheter and a Spiegelberg HDM 26 monitor. Patients were treated according international pediatric guides. The characteristics of both groups are described at 6 months of follow-up.


RESULTS
Forty-two patients (CM=14 and SM=28). Those in the CM Group had lower Glasgow coma scale score and Marshall classification with poorer prognosis. Among them survival rate was lower, although the outcome was from moderate to good. No complications were reported with the use of the ICP catheter.


CONCLUSIONS
Patients with ICP monitoring had greater severity at admission and an increased mortality; however, the outcome for the survivors was from moderate to good. It is necessary to conduct randomized clinical trials to define the impact of ICP monitoring on survival and quality of life in severe TBI patients.
Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México. Electronic address: joseramon.garcia@correo.uady.mx.
José Ramón
JR
García-Lira
Unidad Interinstitucional de Investigación Clínica y Epidemiológica, Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México.
Rita Esther
RE
Zapata-Vázquez
Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México.
Felipe
F
Alonzo-Vázquez
Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México.
Suemy Gabriela
SG
Rodríguez-Ruz
Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México.
Manuel Rene
MR
Medina-Moreno
Facultad de Medicina, Universidad Autónoma de Yucatán, Mérida, Yucatán, México.
Jose Luis
JL
Torres-Escalante
D000293:Adolescent; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011379:Prognosis; D011788:Quality of Life; D015996:Survival Rate; D015599:Trauma Severity Indices
Cerebral perfusion pressure; Intracranial pressure; Presión de perfusión cerebral; Presión intracraneal; Prognostic; Pronóstico; Traumatic brain injury; Traumatismo craneoencefálico