ABSTRACT
Pediatric traumatic brain injury (TBI) represents an important cause of morbidity and mortality. This chapter represents a practice-based approach to treating children with severe TBI, supported by available data and guidelines for the acute management of severe TBI. The treatment of severe TBI is focused on limiting and preventing secondary injury. Systemic changes such as hypotension, hypoxia, hyperglycemia, and hyperthermia can accentuate secondary injury. The Glasgow Coma Scale (GCS) is used to provide a standardized neurological assessment for severe TBI. The standard GCS can be used for children 3 years or older and the pediatric GCS is used for infants up to 2 years of age. The critical care management of severe pediatric TBI patients should focus on maintaining euvolemia, avoiding dehydration and hypotension. Analgesics, sedatives, and neuromuscular blockers are important agents used in the intensive care unit for the management of severe pediatric TBI.
