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. 2021 Oct;37(10):1421-1428.
doi: 10.1007/s00383-021-04959-2. Epub 2021 Jul 7.

Traumatic brain injury in children with thoracic injury: clinical significance and impact on ventilatory management

Caroline Baud  1 , Benjamin Crulli  2 , Jean-Noël Evain  3 , Clément Isola  1 , Isabelle Wroblewski  1 , Pierre Bouzat  3 , Guillaume Mortamet  4
Affiliations

Traumatic brain injury in children with thoracic injury: clinical significance and impact on ventilatory management

Caroline Baud et al. Pediatr Surg Int. 2021 Oct.

Abstract

Purpose: This study aims to describe the epidemiology and management of chest trauma in our center, and to compare patterns of mechanical ventilation in patients with or without associated moderate-to-severe traumatic brain injury (TBI).

Methods: All children admitted to our level-1 trauma center from February 2012 to December 2018 following chest trauma were included in this retrospective study.

Results: A total of 75 patients with a median age of 11 [6-13] years, with thoracic injuries were included. Most patients also had extra-thoracic injuries (n = 71, 95%) and 59 (79%) had TBI. A total of 52 patients (69%) were admitted to intensive care and 31 (41%) were mechanically ventilated. In patients requiring mechanical ventilation, there was no difference in tidal volume or positive end-expiratory pressure in patients with moderate-to-severe TBI when compared with those with no-or-mild TBI. Only one patient developed Acute Respiratory Distress Syndrome. A total of 6 patients (8%) died and all had moderate-to-severe TBI.

Conclusion: In this small retrospective series, most patients requiring mechanical ventilation following chest trauma had associated moderate-to-severe TBI. Mechanical ventilation to manage TBI does not seem to be associated with more acute respiratory distress syndrome occurrence.

Keywords: Chest trauma; Children; Mechanical ventilation; Pulmonary contusion; Traumatic brain injury.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the study
Fig. 2
Fig. 2
Patterns of mechanical ventilation according to the association with (dark grey bars) or without (light grey bars) moderate-to-severe TBI. A tidal volume, B positive end-expiratory pressure (PEEP), C FiO2 and D venous partial pressure of carbon dioxide (PvCO2). Median values and interquartile ranges are presented. ND: no data available
See this image and copyright information in PMC

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