Dataset Information

Relationship between two depth of anaesthesia monitors- Bispectral Index and age adjusted MAC in general anesthesia in children

ABSTRACT: Primary outcome(s): Correlation between bispectral index (BIS) value and age adjusted MAC (aaMAC) valuesTimepoint: every minute during maintenance phase of anaesthesia

DISEASE(S): Congenital Hypertrophic Pyloric Stenosis,Calculus In Bladder,Congenital Absence, Atresia And Stenosis Of Duodenum,Congenital Diaphragmatic Hernia,Acute Appendicitis With Generalized Peritonitis,Bilateral Inguinal Hernia, Withoutobstruction Or Gangrene,Congenital Absence, Atresia And Stenosis Of Anus Without Fistula,Cleft Uvula,Acute Appendicitis With Localizedperitonitis,Congenital Occlusion Of Ureter,Cleft Soft Palate,Congenital Absence, Atresia And Stenosis Of Ileum,Congenital Absence, Atresia And Stenosis Of Jejunum,Benign Neoplasm Of Major Salivaryglands,Congenital Absence, Atresia And Stenosis Of Rectum Without Fistula,Congenital Absence, Atresia And Stenosis Of Anus With Fistula,Duplication Of Ureter,Cystic Disease Of Liver,Ectopic Testis,Cleft Hard Palate With Cleft Softpalate,Cleft Lip, Median,Congenital Absence, Atresia And Stenosis Of Rectum With Fistula,Calculus Of Kidney,Epispadias,Congenital Vesico-uretero-renal Reflux,Esophageal Web,Congenital Chordee,Congenital Posterior Urethral Valves,Encysted Hydrocele,Esophageal Obstruction,Cleft Lip, Bilateral,Cleft Hard Palate,Cleft Lip, Unilateral

PROVIDER: 2587043 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:BACKGROUND:Pediatric casualties account for a notable proportion of encounters in the deployed setting based on the humanitarian medical care mission. Previously published data demonstrates that an age-adjust shock index may be a useful tool in predicting massive transfusion and death in children. We seek to determine if those previous findings are applicable to the deployed, combat trauma setting. METHODS:We queried the Department of Defense Trauma Registry (DODTR) for all pediatric subjects admitted to US and Coalition fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016. This is a secondary analysis of casualties seeking to validate previously published data using the shock index, pediatric age-adjusted. We then used previously published thresholds to determine patients outcome for validation by age grouping, 1-3?years (1.2), 4-6?years (1.2), 7-12?years (1.0), 13-17?years (0.9). RESULTS:From January 2007 through January 2016 there were 3439 pediatric casualties of which 3145 had a documented heart rate and systolic pressure. Of those 502 (16.0%) underwent massive transfusion and 226 (7.2%) died prior to hospital discharge. Receiver operating characteristic (ROC) thresholds were inconsistent across age groups ranging from 1.0 to 1.9 with generally limited area under the curve (AUC) values for both massive transfusion and death prediction characteristics. Using the previously defined thresholds for validation, we report sensitivity and specificity for the massive transfusion by age-group: 1-3 (0.73, 0.35), 4-6 (0.63, 0.60), 7-12 (0.80, 0.57), 13-17 (0.77, 0.62). For death, 1-3 (0.75, 0.34), 4-6 (0.66-0.59), 7-12 (0.64, 0.52), 13-17 (0.70, 0.57). However, negative predictive values (NPV) were generally high with all greater than 0.87. CONCLUSIONS:Within the combat setting, the age-adjusted pediatric shock index had moderate sensitivity and relatively poor specificity for predicting massive transfusion and death. Better scoring systems are needed to predict resource needs prior to arrival, that perhaps include other physiologic metrics. We were unable to validate the previously published findings within the combat trauma population.

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Relationship between two depth of anaesthesia monitors- Bispectral Index and age adjusted MAC in general anesthesia in children

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