How Important Are Arterial Blood Gas Parameters for Severe Head Trauma in Children?

Abstract

Aim: Our aim in this study is to consider the relationship between arterial blood gas (ABG) parameters and prognosis in severe head trauma in children.
 Material and Methods: Patients younger than 17 years of age with a Glasgow Coma Scale (GCS) of 8 and below with a history of head trauma were retrospectively analyzed. The relation of ABG parameters taken at the time of admission with mortality was examined. Independent sample T-test was used for pH, PCO2 and base extract (BE) parameters in ABG, and Mann Whitney U test was used for PO2 and lactate parameters.
 Results: 48 patients were included in the study. Gender, age, admission blood pressure arterial values, GCS and Abbreviated Injury Scale (AIS) scores, length of stay in intensive care, and the surgical application did not differ statistically between the patient groups who died and survived (p> 0.05). Ph and PO2 values were lower, PCO2, lactate and BE values were found to be higher in the deceased patient group compared to the living patient group (p˂0.05). The presence of acidosis, hypercapnia, or hyperlactatemia according to ABG values in the patient group who died was statistically significantly higher (p˂0.05).
 Conclusion: In our study, we found that the presence of acidosis, hypercapnia, and hyperlactatemia in patients according to ABG values increased mortality. In addition, according to the results of ROC analysis, we found that high PCO2 and lactate values could be specific indicators indicating poor prognosis. We think that PCO2 and lactate measured in arterial blood may be biomarkers that can determine the prognosis.