Future Studies and Conclusions
Traumatic brain injuries differ between children and adults. Although it is believed that the immature brain recovers more fully from TBI, studies indicate that cerebral edema after TBI is three times more likely to occur in children than in adults. This suggests that a novel therapy such as progesterone, which decreases cerebral edema, may have a greater effect on children than adults. Although neurocognitive outcomes are better for children than for adults after TBI in general, neurocognitive recovery and its measurement after TBI are dependent on age and developmental level.[94,95] Because of the differences between children and adults, and the lack of effective treatment for TBI, there is a need to complete the preclinical studies necessary to prepare for a potential pediatric clinical trial of progesterone administration. The results of this research could lead to the development of a novel neuroprotective therapy with potential to reduce the profound long-term disability in head-injured children. This information could also contribute to the use of progesterone in the treatment of pediatric brain injury from other causes (cardiac arrest, stroke, and seizures).
We thank Ms. Blair Anton, Associate Director of Clinical Information Services with the Johns Hopkins University Welch Library, for her assistance with compilation of published studies for Supplemental Table 1 (Supplemental Digital Content 1, https://links.lww.com/PCC/A129).
Pediatr Crit Care Med. 2015;16(3):236-244. © 2015 Lippincott Williams & Wilkins