National characteristics, etiology, and inpatient outcomes of pediatric traumatic brain injury: a KID study

Lu, Victor M.; Hernandez, Nicole E; Wang, Shelly

doi:10.1007/s00381-022-05544-1

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…Because there can be sex differences in the response to TBI ( 43 , 44 ) and TBI in the young and in military personnel is more prevalent in males ( 45 ), the study was conducted in male pigs. A total of 48 pigs weighing 28 ± 2 kg and approximately 3 months of age were used in the overall study.…”

Section: Methodsmentioning

confidence: 99%

“…To determine whether protection can occur independent of effects on MAP, we conducted a second experiment to test the efficacy of PNPH infusion after TBI alone. Because there can be sex differences in the response to TBI (43,44) and TBI in the young and in military personnel is more prevalent in males (45), the study was conducted in male pigs. A total of 48 pigs weighing 28 ± 2 kg and approximately 3 months of age were used in the overall study.…”

Section: Introductionmentioning

confidence: 99%

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Polynitroxylated PEGylated hemoglobin protects pig brain neocortical gray and white matter after traumatic brain injury and hemorrhagic shock

Wang

Shi

Cao

et al. 2023

Front. Med. Technol.

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Polynitroxylated PEGylated hemoglobin (PNPH, aka SanFlow) possesses superoxide dismutase/catalase mimetic activities that may directly protect the brain from oxidative stress. Stabilization of PNPH with bound carbon monoxide prevents methemoglobin formation during storage and permits it to serve as an anti-inflammatory carbon monoxide donor. We determined whether small volume transfusion of hyperoncotic PNPH is neuroprotective in a porcine model of traumatic brain injury (TBI) with and without accompanying hemorrhagic shock (HS). TBI was produced by controlled cortical impact over the frontal lobe of anesthetized juvenile pigs. Hemorrhagic shock was induced starting 5 min after TBI by 30 ml/kg blood withdrawal. At 120 min after TBI, pigs were resuscitated with 60 ml/kg lactated Ringer's (LR) or 10 or 20 ml/kg PNPH. Mean arterial pressure recovered to approximately 100 mmHg in all groups. A significant amount of PNPH was retained in the plasma over the first day of recovery. At 4 days of recovery in the LR-resuscitated group, the volume of frontal lobe subcortical white matter ipsilateral to the injury was 26.2 ± 7.6% smaller than homotypic contralateral volume, whereas this white matter loss was only 8.6 ± 12.0% with 20-ml/kg PNPH resuscitation. Amyloid precursor protein punctate accumulation, a marker of axonopathy, increased in ipsilateral subcortical white matter by 132 ± 71% after LR resuscitation, whereas the changes after 10 ml/kg (36 ± 41%) and 20 ml/kg (26 ± 15%) PNPH resuscitation were not significantly different from controls. The number of cortical neuron long dendrites enriched in microtubules (length >50 microns) decreased in neocortex by 41 ± 24% after LR resuscitation but was not significantly changed after PNPH resuscitation. The perilesion microglia density increased by 45 ± 24% after LR resuscitation but was unchanged after 20 ml/kg PNPH resuscitation (4 ± 18%). Furthermore, the number with an activated morphology was attenuated by 30 ± 10%. In TBI pigs without HS followed 2 h later by infusion of 10 ml/kg LR or PNPH, PNPH remained neuroprotective. These results in a gyrencephalic brain show that resuscitation from TBI + HS with PNPH protects neocortical gray matter, including dendritic microstructure, and white matter axons and myelin. This neuroprotective effect persists with TBI alone, indicating brain-targeting benefits independent of blood pressure restoration.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Polynitroxylated PEGylated hemoglobin protects pig brain neocortical gray and white matter after traumatic brain injury and hemorrhagic shock

Wang

Shi

Cao

et al. 2023

Front. Med. Technol.

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“…Using the KID, Lu et.al identified 220,771 pediatric cases of TBI between 2006 and 2012, 66% of which occurred among boys. They reported a mean hospital length of stay of 5 days and an in-hospital mortality rate of 4% ( 5 ). Piatt used the KID to determine that the incidence of hospital admission for SCI among individuals aged 21 or younger was 24 per 1 million in 2009.…”

Section: Introductionmentioning

confidence: 99%

Dual diagnosis of TBI and SCI: an epidemiological study in the pediatric population

Gober,

Shapiro,

Tiozzo

et al. 2023

Front. Neurol.

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IntroductionDual diagnosis (DD) with traumatic brain injury (TBI) and spinal cord injury (SCI) poses clinical and rehabilitation challenges. While comorbid TBI is common among adults with SCI, little is known about the epidemiology in the pediatric population. The primary objective of this study was to evaluate the prevalence of TBI among children in the United States hospitalized with SCI. Secondary objectives were to compare children hospitalized with DD with those with isolated SCI with regards to age, gender, race, hospital length of stay, and hospital charges.MethodsA retrospective analysis of hospital discharges among children aged 0–18 years occurring between 2016–2018 from U.S. hospitals participating in the Kids’ Inpatient Database. ICD-10 codes were used to identify cases of SCI, which were then categorized by the presence or absence of comorbid TBI.Results38.8% of children hospitalized with SCI had a co-occurring TBI. While DD disproportionately occurred among male children (67% of cases), when compared with children with isolated SCI, those with DD were not significantly more likely to be male. They were more likely to be Caucasian. The mean age of children with DD (13.2 ± 5.6 years) was significantly less than that of children with isolated SCI (14.4 ± 4.3 years). DD was associated with longer average lengths of stay (6 versus 4 days) and increased mean total hospital charges ($124,198 versus $98,089) when compared to isolated SCI.ConclusionComorbid TBI is prevalent among U.S. children hospitalized with SCI. Future research is needed to better delineate the impact of DD on mortality, quality of life, and functional outcomes.

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National characteristics, etiology, and inpatient outcomes of pediatric traumatic brain injury: a KID study

Cited by 2 publications

References 22 publications

Polynitroxylated PEGylated hemoglobin protects pig brain neocortical gray and white matter after traumatic brain injury and hemorrhagic shock

Polynitroxylated PEGylated hemoglobin protects pig brain neocortical gray and white matter after traumatic brain injury and hemorrhagic shock

Dual diagnosis of TBI and SCI: an epidemiological study in the pediatric population

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