Abstract PR141

Abstract

Background & Objectives: There is a paucity of literature with regard to intracranial pressure (ICP) monitoring in children. The present study aims to find out the utility of ICP monitoring in children with severe traumatic brain injury (TBI). Materials & Methods: Medical records of children of one to 12 years admitted to neurointensive care unit with severe TBI over a period of two years were reviewed. The children were divided into two groups (Study Group: ICP monitored and Control Group: ICP was not monitored). Admission demographics, vital parameters, computed tomographic (CT) scan findings were recorded. In the study group, date of ICP catheter insertion/removal with ICP values and treatment for increased ICP, was noted. Data on tracheostomy, duration of mechanical ventilation, hospital stay, outcome at-discharge, were noted. Appropriate statistical analysis was done. Results: Demographic variables were comparable in between the two groups. When adjusted for death, there was no significant difference in median duration of mechanical ventilation [35(95%CI 12–73) days in study group vs 55(95%CI 29–55) days in control group; p=0.96], hospital stay [36(95%CI 12–73) days in study group vs 58(95%CI 29–58) days in control group; p=0.96]; time to tracheostomy was 6(95%CI 5–8) days in study group vs 5(95%CI 4–7) days in control group (p=0.49). Mortality rates, incidence of cranial surgeries, outcome at discharge were comparable in both the groups. Age at admission and initial GCS 3–5 were the only predictors significant for outcome at discharge on multivariate analysis. Conclusion: In this study, ICP monitoring was safely carried out in children with severe TBI. However, this monitoring did not reduce the incidence of death, cranial surgeries, duration of mechanical ventilation, hospital stay, or improve the outcome at discharge, when compared to similar group of children who were managed without ICP monitoring. The GCS score and age at admission were the main predictors of outcome at discharge. Disclosure of Interest: None declared