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

Journal Article (Journal Article)


Severe traumatic brain injury (TBI) is associated with high rates of death and disability. As a result, the revised guidelines for the management of pediatric severe TBI address some of the previous gaps in pediatric TBI evidence and management strategies targeted to promote overall health outcomes.


To provide highlights of the most important updates featured in the third edition of the guidelines for the management of pediatric severe TBI. These highlights can help critical care providers apply the most current and appropriate therapies for children with severe TBI.

Methods and results

After a brief overview of the process behind identifying the evidence to support the third edition guidelines, both relevant and new recommendations from the guidelines are outlined to provide critical care providers with the most current management approaches needed for children with severe TBI. Recommendations for neuroimaging, hyperosmolar therapy, analgesics and sedatives, seizure prophylaxis, ventilation therapies, temperature control/hypothermia, nutrition, and corticosteroids are provided. In addition, the complete guideline document and its accompanying algorithm for recommended therapies are available electronically and are referenced within this article.


The evidence base for treating pediatric TBI is increasing and provides the basis for high-quality care. This article provides critical care providers with a quick reference to the current evidence when caring for a child with a severe TBI. In addition, it provides direct access links to the comprehensive guideline document and algorithms developed to support critical care providers.

Full Text

Duke Authors

Cited Authors

  • Reuter-Rice, K; Christoferson, E

Published Date

  • January 2020

Published In

Volume / Issue

  • 29 / 1

Start / End Page

  • e13 - e18

PubMed ID

  • 31968082

Electronic International Standard Serial Number (EISSN)

  • 1937-710X

International Standard Serial Number (ISSN)

  • 1062-3264

Digital Object Identifier (DOI)

  • 10.4037/ajcc2020228


  • eng