Heart Rate Variability in Children With Traumatic Brain Injury

Heart Rate Variability in Children With Traumatic Brain Injury and Neurological Outcome

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.

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.

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.