Autoregulation in the intensive care unit and outcome after pediatric traumatic brain injury

Principal Investigator: Cynthia Salorio

Traumatic brain injury (TBI) is a leading cause of death and disability in children. One of the goals of rehabilitation research is to identify factors that impact long term outcomes after injury. Studies have suggested that acute physiologic variables, such as blood pressure and hypertension, during the early hospitalization period after pediatric TBI may be predictive of long-term outcomes.

Preserved autoregulation has been found to be associated with survival after severe head trauma in children. However, the long term outcomes of autoregulation in the intensive care unit have not been well investigated. This study proposes to examine the short and long term outcomes of autoregulation on mortality, and on cognitive, behavioral and/or functional variables in pediatric TBI patients.

This study will be a retrospective record review. Participants will be all children who were admitted to the Johns Hopkins Hospital Pediatric Intensive Care Unit (PICU) from March 1 , 2007 to March 10, 2009. We plan to review records and extract existing medical data that was collected as part of routine clinical care during the PICU stay, including variables related to temperature, blood pressure, intercranial pressure, and autoregulation. Record reviews from Johns Hopkins and Kennedy Krieger will also be conducted to extract any existing information regarding outcomes, including mortality, functional status at follow-up appointments, and any test data done through Kennedy Krieger's rehabilitation program for those children who participated in this program. Once this data is collected, we will create a database that is de-identifed of all protected health information.

We hope to examine what clinically obtained variables are useful in predicting both short and long term outcomes after pediatric TBI to assist in planning prospective studies.