Pediatric severe traumatic brain injury mortality prediction determined with machine learning-based modeling.

Introduction: Severe traumatic brain injury (sTBI) is a leading cause of mortality in children. As clinical prognostication is important in guiding optimal care and decision making, our goal was to create a highly discriminative sTBI outcome prediction model for mortality.

Methods: Machine learning and advanced analytics were applied to the patient admission variables obtained from a comprehensive pediatric sTBI database.

Development of a Mortality Prediction Tool in Pediatric Severe Traumatic Brain Injury.

Severe traumatic brain injury (sTBI) is a leading cause of pediatric death, yet outcomes remain difficult to predict. The goal of this study was to develop a predictive mortality tool in pediatric sTBI. We retrospectively analyzed 196 patients with sTBI (pre-sedation Glasgow Coma Scale [GCS] score <8 and head Maximum Abbreviated Injury Scale (MAIS) score >4) admitted to a pediatric intensive care unit (PICU).

Corrigendum to "Designing and evaluating an automated intravenous dosage medication calculation tool for reducing the time of stat medication administration in a pediatric emergency department" [Heliyon 6 (6) (June 2020) Article e04140].

[This corrects the article DOI: 10.1016/j.heliyon.

Designing and evaluating an automated intravenous dosage medication calculation tool for reducing the time of stat medication administration in a pediatric emergency department.

Background: Urgent medications are regularly prescribed using the term "stat", which indicates that the medication should be administered within 30 min after it is ordered. However, many hospitals struggle to reliably administer stat medications within 30 min after they are ordered. This study involved developing and evaluating an automated intravenous dosage medication calculation tool (AIVDMCT) for reducing the time between the order and administration of stat medications to children at a pediatric emergency department (PED) in Saudi Arabia.

Identification of adverse events in pediatric severe traumatic brain injury patients to target evidence-based prevention for increased performance improvement and patient safety.

Introduction: Trauma centres are required to continuously measure, evaluate and improve care. Severe traumatic brain injury (sTBI) patients are highly susceptible to adverse events (AE; unintended, potentially harmful events resulting from health care) due to their unstable condition requiring high risk interventions, multiple medications and invasive monitoring. Objectives were to describe: (1) a process for identifying AE in pediatric sTBI patients to identify safety risks, target and implement evidence-based prevention strategies; and (2) a tertiary care PICU's sTBI AE experience.

Basal skull fractures are associated with mortality in pediatric severe traumatic brain injury.

Background: Basal skull fractures (BSFs) are caused by blunt force trauma, occurring in the temporal, occipital, sphenoid, and/or ethmoid bones. In pediatric severe traumatic brain injury (sTBI), there is a paucity of data on BSFs. Our goal was to investigate the BSF prevalence, anatomy, and association with short-term outcomes in pediatric sTBI.

Hyperosmolar hyperglycemic state without ketosis in a toddler with type 1 diabetes.

We present a thin toddler whose initial presentation with type 1 diabetes was hyperglycemic hyperosmolar syndrome without diabetic ketoacidosis after ingestion of copious quantities of high-sugar beverages. Increasing consumption of high-sugar beverages may make this presentation of type 1 diabetes mellitus more common. Emergency care physicians must be aware of this potential clinical constellation in the very young, as management differs significantly from that accepted for diabetic ketoacidosis in children.

Subarachnoid hemorrhage prevalence and its association with short-term outcome in pediatric severe traumatic brain injury.

Background: Subarachnoid hemorrhage (SAH) is an independent prognostic indicator of outcome in adult severe traumatic brain injury (sTBI). There is a paucity of investigations on SAH in pediatric sTBI. The goal of this study was to determine in pediatric sTBI patients SAH prevalence, associated factors, and its relationship to short-term outcome.

CXCL1/CXCL8 (GROα/IL-8) in human diabetic ketoacidosis plasma facilitates leukocyte recruitment to cerebrovascular endothelium in vitro.

Diabetic ketoacidosis (DKA) in children is associated with intracranial vascular complications, possibly due to leukocyte-endothelial interactions. Our aim was to determine whether DKA-induced inflammation promoted leukocyte adhesion to activated human cerebrovascular endothelium. Plasma was obtained from children with type 1 diabetes either in acute DKA or in an insulin-controlled state (CON).

The role of serious concomitant injuries in the treatment and outcome of pediatric severe traumatic brain injury.

Background: The study objective was to describe the epidemiology of serious concomitant injuries and their effects on outcome in pediatric severe traumatic brain injury (sTBI).

Methods: A retrospective cohort of all severely injured (Injury Severity Score [ISS] ≥ 12) pediatric patients (<18 years) admitted to our pediatric intensive care unit, between 2000 and 2011, after experiencing an sTBI (Glasgow Coma Scale [GCS] score ≤ 8 and head Abbreviated Injury Scale [AIS] ≥ 4) were included. Two groups were compared based on the presence of serious concomitant injuries (maximum AIS score ≥ 3).

Infection rates, fevers, and associated factors in pediatric severe traumatic brain injury.

Abstract Infections can increase medical costs and worsen patient outcomes. Our aims in pediatric severe traumatic brain injury (sTBI) patients were to determine the infection and fever rates, and to report on associated clinical, imaging, treatment, and outcome factors. We included 180 sTBI patients (presedation Glasgow Coma Scale ≤ 8 and Maximum Abbreviated Injury Scale ≥ 4) admitted to our pediatric intensive care unit.

Brain injury biomarkers as outcome predictors in pediatric severe traumatic brain injury.

Background: To systematically review the literature on brain injury biomarkers, defined as any injury biomarker detected in cerebrospinal fluid (CSF) or blood injury biomarkers primarily expressed in the brain parenchyma, to determine outcome prediction in pediatric severe traumatic brain injury (sTBI).

Methods: A search of MEDLINE(®), EMBASE(®), PsycINFO(®), Pubmed(®), and the Cochrane Database, as well as grey literature sources, personal contacts, hand searches, and reference lists. The search terms used were traumatic brain injury, biomarkers, prognosis, and children.

Coagulation assessment in children with diabetic ketoacidosis.

Objectives: To assess potential hypercoagulability during diabetic ketoacidosis in children.

Design: A prospective, controlled pilot study.

Setting: University-affiliated pediatric critical care unit and emergency department in a tertiary care children's hospital.

Central diabetes insipidus in pediatric severe traumatic brain injury.

Objectives: To determine the occurrence rate of central diabetes insipidus in pediatric patients with severe traumatic brain injury and to describe the clinical, injury, biochemical, imaging, and intervention variables associated with mortality.

Design: Retrospective chart and imaging review.

Setting: Children's Hospital, level 1 trauma center.

Hypernatremia is associated with increased risk of mortality in pediatric severe traumatic brain injury.

Acquired hypernatremia in hospitalized patients is often associated with poorer outcomes. Our aim was to evaluate the relationship between acquired hypernatremia and outcome in children with severe traumatic brain injury (sTBI). We performed a retrospective cohort study of all severely injured trauma patients (Injury Severity Score ≥12) with sTBI (Glasgow Coma Scale [GCS] ≤8 and Maximum Abbreviated Injury Scale [MAIS] ≥4) admitted to a Pediatric Critical Care Unit ([PCCU]; 2000-2009).