Table 3.

Recommendations for management of pediatric TBI. Derived from Sung A, et al. (2018)⁷⁵

Scopes of pediatric TBI management
Sedative choice	Hyperventilation to be applied	Hyperosmolar agents effectiveness	Control of body temperature	Diabetes management	Neuroimaging indications	Monitoring pressure inside the skull	Preventive anticonvulsant
Clinical considerations
The average blood pressure should be preserved during the tracheal intubation and any other invasive procedures	Hyperventilation could cause cerebral infarction or/and ischemic stroke	The solution of 3% hypertonic saline would decrease the requirement for attendant interventions for treatment of inappropriate pressure inside the skull	Hypothermia condition would cause heart arrhythmia and higher mortality rate	Higher levels of blood glucose could cause adverse side effects	Pediatric emergency care applied research network (PECARN) proposes to immediately monitor children based on glasgow coma scale	-	Whenever post-traumatic seizures risk factors appeared, anticonvulsant agents must be applied
Approved recommendations
Whenever volume depletion or hypotension appeared, ketamine should be applied. Additionally, when where was an absence of adrenal insufficiency, etomidate must be considered.	Prevent from hyperventilation condition when partial pressure of carbon dioxide lower than 300 mmHg	The recommended amount of hypertonic saline is 3%	The body temperature is recommended to maintain in normal condition	The level of sugar in the blood is recommended to be normal	The clinical effectiveness of conducting PECARN is to help clinical specialists in making emergency decision or brain imaging	There not any proved documents on ordinary application of monitoring for controlling the pressure inside the skull	There is not any proved documents for ordinary application of preventive anticonvulsant agents