Randomized Trial Comparing Two Treatment Protocols for Severe Traumatic Brain Injury in Children Aged 1 to 12 in Latin America
Led by University of Washington · Updated on 2025-06-27
428
Participants Needed
11
Research Sites
N/A
Total Duration
AI-Summary
What this Trial Is About
Researchers are evaluating two different management protocols for children aged 1 to 12 years with severe traumatic brain injury sTBI in Latin America. The study aims to determine if using a treatment approach guided by invasive intracranial pressure ICP monitoring leads to better outcomes compared to a protocol based solely on imaging and clinical exams. This trial builds on previous adult studies and addresses the unique needs of pediatric patients to improve care and guide global clinical practice.
The study randomly assigns children to one of two treatment groups. One group receives care following a protocol that uses invasive ICP monitoring to guide management decisions, based on recommendations from the Brain Trauma Foundation Guidelines. The other group follows the CREVICE protocol, which manages sTBI using imaging and clinical examination without ICP monitoring. Both protocols focus on aggressive management of sTBI. The trial is conducted in eight pediatric intensive care units in Latin America, aiming to strengthen research skills among local pediatric intensivists.
Participants will be closely monitored during their hospital stay, with the study measuring outcomes such as quality of life using the Pediatric Quality of Life Inventory PedsQL at three and six months, functional recovery with the Glasgow Outcome Scale - Extended Pediatric GOS-E Peds, mortality rates, brain-specific treatments, and length of stay in intensive care. Data will be collected for up to six months after injury to assess the effects of the two management strategies on recovery and complications.
CONDITIONS
Brief Title
Benchmark Evidence Led by Latin America: Trial of Intracranial Pressure - Pediatrics
Research Team
R
Randall M Chesnut, MD
K
Kelley Chaddock, BA
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Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Collaborating Sponsor
How This Trial Compares With Other Options
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
Factors
ICP Monitoring Protocol
Imaging and Clinical Exam Protocol (No ICP Monitoring)
What it is
A standardized protocol for managing severe pediatric traumatic brain injury that uses an ICP monitor to guide brain-directed treatments.
A protocol for managing severe pediatric traumatic brain injury based on clinical examinations and brain imaging, without using ICP monitoring.
Role in trial
Children are randomly assigned to receive treatment guided by ICP monitoring to determine if outcomes improve compared to an imaging and clinical exam-guided approach.
Children are randomly assigned to management based on clinical signs and imaging, testing if this approach is comparable to management guided by ICP monitoring.
Primary use
To monitor intracranial pressure and guide treatment decisions aimed at optimizing neurological outcome in severe pediatric traumatic brain injury.
To use clinical examinations and brain imaging findings alone to guide treatment decisions in children with severe TBI.
How it is given or performed
Requires surgical placement of an intracranial pressure monitor, with brain-directed therapies adjusted according to real-time pressure readings.
Relies on frequent clinical neurological checks and interpretation of brain CT or MRI scans, without placement of monitoring devices.
Evidence status
Effectiveness of ICP-guided management for improving quality of life or neurological outcome in children with severe traumatic brain injury is being evaluated in this randomized trial; results are not yet available.
Whether management without ICP monitoring is as effective as ICP-guided management remains under investigation; current evidence has not established a clear advantage of one protocol over the other in children.
Important limitations
Requires surgery to place a monitoring device, which carries procedural risks; optimal ICP thresholds and intervention protocols are still debated in children.
Relies on intermittent clinical assessments and imaging, which may miss changes in intracranial pressure or neurological deterioration between evaluations.
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
Who Can Participate
Age: 1Year - 12Years
All Genders
Eligibility Criteria
You may qualify if you...
Signed informed consent from parent or guardian
Non-penetrating traumatic brain injury
Admission to study hospital within 24 hours of injury
Glasgow Coma Scale score of 8 or less on admission or within 48 hours after injury
Age between 1 and 12 years
Ability to randomize within 24 hours of injury or deterioration to GCS 8 or less
You will not qualify if you...
Motor Glasgow Coma Scale score of 6
Glasgow Coma Scale score of 3 with bilaterally fixed and dilated pupils
Injury believed to be intentionally caused by a family member or caregiver
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Treatment
Duration - Approximately 1 month
Participants receive one of two management protocols for severe traumatic brain injury: one using intracranial pressure monitoring to guide treatment and the other using imaging and clinical examination without intracranial pressure monitoring.
Continuous monitoring during hospital stay in ICU
Follow-up
Duration - 6 months after injury
Participants are followed for assessment of quality of life, functional recovery, and survival after injury.
Visits at 3 and 6 months post-injury
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Development of a Randomized Trial Comparing ICP-Monitor-Based Management of Severe Pediatric Traumatic Brain Injury to Management Based on Imaging and Clinical Examination Without ICP Monitoring-Study Protocol.
Development of a Randomized Trial Comparing ICP-Monitor-Based Management of Severe Pediatric Traumatic Brain Injury to Management Based on Imaging and Clinical Examination Without ICP Monitoring-Research Algorithms.