Effects of Head Elevation on Intracranial Pressure in Children

Not Applicable

Completed

• Conditions: Head Injury
• Interventions: Procedure: Place HOB in alternate positions from 0-50 degrees.

• Registration Number: NCT00636376
• Lead Sponsor: Children's Hospital of Philadelphia

Brief Summary

Head injury is the most common cause of mortality and acquired disability in childhood. It is common to elevate the head of patients at risk for increased intracranial pressure, although it is not clear if it is always beneficial. Every severe pediatric traumatic brain injured patient will have an optimal head position that prevents rising pressure in the brain.

Detailed Description

Head injury is the most common cause of mortality and acquired disability on childhood. Management of children at risk for intracranial hypertension is both complex and increasingly controversial. Also, effect of head position on intracranial pressure, cerebral perfusion pressure, adn cerebral venous outflow in the pediatric population has not been studied. We will examine the effect of head positioning on ICP, CPP, and cerebral venous outflow in pediatric patients at risk for intracranial hypertension. The hypothesis is that ICP will be reduced with improvement in cerebral venous outflow by each patient having their own optimal head position.

Study Timeline

• Study Start: 2002-01
• Study First Submitted: 2008-03-11
• Study First Submitted QC: 2008-03-13
• Study First Posted: 2008-03-14
• Status Verified: 2008-10
• Primary Completion: 2008-10
• Study Completion: 2008-10
• Last Update Submitted: 2008-10-20
• Last Update Posted: 2008-10-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 18

Inclusion Criteria

• Neonates, children, and adolescents
• Intracranial pressure monitor in place

Exclusion Criteria

• Severe multiorgan system failure
• Hemodynamic instability sufficient to preclude changes in head position

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
1	Place HOB in alternate positions from 0-50 degrees.	Single arm--no randomization. All subjects enrolled will have vitals collected and three ultrasounds at different levels of head of the bed elevations.

Primary Outcome Measures

Name	Time	Method
ICP will be reduced with improvement in cerebral venous outflow which is dependent on intravascular volume status and intrathoracic pressure and each will have their own optimal head position.	As long as ICP is being monitored.

Trial Locations

Locations (1)

The Children's Hospital of Philadelphia; 🇺🇸 Philadelphia, Pennsylvania, United States