ICP and CPP: excellent predictors of long term outcome in severely brain injured children

Abstract

Objective: To determine the predictive powers of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) amongst severely brain injured children.

Materials and methods: ICP and CPP were recorded from thirty-five severely brain injured children who were prospectively recruited after admission to paediatric intensive care. Twenty-five suffered traumatic brain injury (TBI) and ten suffered non-TBI. Peak ICP and minimum CPP recorded for each patient during their admission were related to 5 year Glasgow Outcome Scale outcome. Receiver operator characteristic curves determined that the optimum threshold for unfavourable outcome prediction was >or=40 mmHg for ICP and <or=49 mmHg for CPP. At these thresholds the sensitivity/specificity pairs for the prediction of unfavourable outcome were 33.3/100% and 55.6/100% for ICP and CPP, respectively, amongst patients suffering TBI and were 46.2/100% and 66.2/100% for ICP and CPP, respectively, amongst all patients.

Conclusion: ICP and CPP are accurate predictors of unfavourable outcome.