Faculty Collaboration Database

The incidence and risk factors for hypotension during emergent decompressive craniotomy in children with traumatic brain injury. Anesth Analg 2006 Oct;103(4):869-75

Date

09/27/2006

Pubmed ID

17000796

DOI

10.1213/01.ane.0000237327.12205.dc

Scopus ID

2-s2.0-33750082389 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

We conducted a retrospective cohort study in children <13 yr with traumatic brain injury (TBI) at a Level 1 pediatric trauma center to describe risk factors for intraoperative hypotension (IH) during emergent decompressive craniotomy. Between 1994 and 2004, 108 children underwent emergent decompressive craniotomy for TBI. Overall, 56 (52%) patients had IH. Independent risk factors for IH were each 10 mL estimated blood loss/kg (ARR 1.15 95% CI 1.08-1.22), each mm of computed tomography (CT) midline shift (ARR 1.04 95%CI 1.01-1.07), each 10 mL of CT lesion volume (ARR 1.03 95%CI 1.01-1.05), and emergency department (ED) hypotension (5/5 patients with ED hypotension had IH). CT midline shift > or =4 mm predicted IH (ARR 1.67 95% CI 1.06-2.63), independent of blood loss. IH occurred frequently during emergent decompressive craniotomy in children with TBI. ED hypotension, blood loss, CT lesion volume, and CT midline shift predicted IH. Anesthesiologists can expect children with preoperative CT midline shift > or =4 mm to have IH during this procedure.

Author List

Miller P, Mack CD, Sammer M, Rozet I, Lee LA, Muangman S, Wang M, Hollingworth W, Lam AM, Vavilala MS

Author

Marjorie Wang MD Clinical Transformation Officer, Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Anesthesia, General
Brain Injuries
Child, Preschool
Craniotomy
Female
Fentanyl
Humans
Hypotension
Infant
Intraoperative Complications
Isoflurane
Male
Methyl Ethers
Radiography
Retrospective Studies
Risk Factors