Child Development, Traumatic Brain Injury
Conditions
Brief summary
Using a prospective cohort of children admitted to the PICU, the investigators will determine HRV monitoring is feasible, if a decreased HRV in the 7 days following moderate or severe TBI in children is associated with a worse outcome 6 months post-TBI and investigate HRV as a tool that can predict adverse events (neurological crisis) within 2 days following TBI.
Detailed description
This is a single center prospective cohort study of 15 children \<18 years, admitted to the PICU at the CHU Sainte-Justine (CHUSJ) with moderate or severe TBI (\<24 hours). Neurodevelopment outcome of children will be evaluated 6 months post TBI.
Interventions
DIAGNOSTIC_TESTHRV monitoring
HRV monitoring derived from electrocardiogram
Sponsors
St. Justine's Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* \<18 years * admitted to the PICU at the CHUSJ * moderate TBI (Glasgow Coma Scale (GCS): 9-12) or severe TBI (GCS ≤8) as - - assessed 30 minutes after TBI or upon arrival in the emergency room * written parental consent.
Exclusion criteria
* children fulfilling brain death criteria at the time of PICU admission (GCS 3 and loss of all brain stem reflexes) * children with a pacemaker or with previously diagnosed arrhythmia (HRV monitoring not reliable) * inflicted trauma (different underlying pathophysiology) * patients or parents who do not speak or read English or French.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| % of the time with reliable HRVmonitoring in children with TBI | 1 year | Feasibility of having a reliable capture and analysis of HRV 7 days post TBI |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of adverse events preceded by a decreased HRV | 1 year | Adverse events will be defined as increased intracranial pressure, decreased CPP, seizure and cardiac arrest |
| HRV and neurological outcome | 1.5 year | The primary outcome of neurological and functional outcome will be assessed by the Pediatric Glasgow Outcome Scale Extended (P-GOSE) 6 months post TBI. P-GOSE is an 8-point ordinal scale (1= best outcome) The score will be classified as favourable (P-GOSE 1 or 2, or decreased of P-GOSE of 1 point post PICU (∆ P-GOSE ≤1) or unfavourable (P-GOSE ≥3 or ∆ P-GOSE ≥2) |
Countries
Canada
Outcome results
None listed