Pediatric trauma made simple.

Abstract

At present, similar to the adult, conventional management in the child following TBI appropriately attempts to lessen the second insults that occur after the injury and the effects of the secondary physiologic events. Many of the treatment modalities used for the child after severe TBI have been extrapolated from the adult data, as there is little literature that primarily involves children. Though children as a group overall have a better outcome than adults, there are many factors that influence prognosis in the pediatric population. The age at injury, mechanism of injury, injury severity, multiple trauma, second insults, and/or the extent of secondary injury can all impact on the final outcome. It is clear that many of the poor outcomes observed are best prevented by preventing either the initial impact or the second insults that typically occur following TBI. Interestingly, very young and preschool children have worse outcomes both in mortality and long-term disability than older children and adolescents. The deficits observed are often persistent and severe in the long term even with aggressive management. Continued aggressive intervention to prevent secondary injury and, in the future, mechanistically targeted therapeutic modalities in the acute setting will hopefully improve the mortality rates and functional recovery in these children.