Critical Update on the Third Edition of the Guidelines for Managing Severe Traumatic Brain Injury in Children

Karin Reuter-Rice, PhD, CPNP-AC; Elise Christoferson, BA


Am J Crit Care. 2020;29(1):e13-e18. 

In This Article


Critical care providers play a vital role in the recognition, management, and treatment of pediatric severe TBI. Beginning and maintaining the appropriate course of care throughout a patient's hospitalization can directly influence a patient's risk of morbidity and mortality. "Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition: Update of the Brain Trauma Foundation Guidelines" provides evidence for best practice in the care of pediatric patients with severe TBI to promote improved patient outcomes. Such best-practice interventions include administration of 3% hypertonic saline in patients with acute intracranial hypertension, providing antiseizure prophylaxis to reduce the occurrence of early posttraumatic seizures, and initiating early enteral support within 72 hours from time of injury to reduce morbidity and mortality. As the number of children with severe TBI continues to grow, much work still must be done to continue to develop and advance evidence-based treatment to improve outcomes for children who sustain severe TBI.