P0008 / #640: EPIDEMIOLOGY AND INITIAL CLINICAL MANAGEMENT OF PEDIATRIC HEAD TRAUMA IN A BRAZILIAN TRAUMA CENTER – RESULTS OF A 2-YEAR RETROSPECTIVE COHORT

Abstract

Aims & Objectives: Traumatic Brain Injury (TBI) poses a significant healthcare concern given the developmental consequences of early brain damage. Studies show that TBI contributes to 20-50% of pediatric injuries in different populations. This study aims to describe the epidemiologic characteristics and initial management of a 2-year cohort of TBI cases in Brazil. Methods: This observational study was conducted in a tertiary trauma center in Sao Paulo using clinical data registry of children (age 1month – 18 years) admitted from July 2017 to December 2019 after a diagnosis of TBI, with an initial Glasgow Coma Scale (GCS) of 3-12. All the records were reviewed. The main outcome measure was PICU mortality. Results: We included 66 patients (73% males), with a mean age of 7.5 years, in the study period. According to the initial GCS, 61% had severe and 26% moderate TBI. 19 patients did not have a reported GCS at admission and were included on basis of clinical evolution. The most used sedatives were Fentanyl (94%) and Propofol (88%), with an average 5.9 days of continuous sedation. Despite neuroprotective measures, 32% of patients needed osmotic agents for intracranial pressure control, 23% needed barbiturate coma therapy and 5% decompressive craniotomy. Mean PICU LOS was 8 days and mean MV duration was 5 days, but still 16 patients required tracheostomy. 4 patients (6%) died during PICU stay, 2 of these deaths declared by neurological criteria. Conclusions: TBI represent a relevant cause of death and disability in children and can be prevented by proper vigilance and safe driving practices.