Guidelines for the management of pediatric severe traumatic brain injury, third edition: Update of the brain trauma foundation guidelines

Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the U.S. Army Contracting Command, Aberdeen Proving Ground, Natick Contracting Division, Stanford University, or the Brain Trauma Foundation. The information contained in the Guidelines for the Management of Pediatric Severe Traumatic Brain Injury reflects the current state of knowledge at the time of publication. The Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons, and other collaborating organizations are not engaged in rendering professional medical services and assume no responsibility for patient outcomes resulting from application of these general recommendations in specific patient circumstances. Accordingly, the Brain Trauma Foundation, American Association of Neurological Surgeons, and Congress of Neurological Surgeons consider adherence to these clinical practice guidelines will not necessarily assure a successful medical outcome. The information contained in these guidelines reflects published scientific evidence at the time of completion of the guidelines and cannot anticipate subsequent findings and/or additional evidence, and therefore should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same result. Medical advice and decisions are appropriately made only by a competent and licensed physician who must make decisions in light of all the facts and circumstances in each individual and particular case and on the basis of availability of resources and expertise. Guidelines are not intended to supplant physician judgment with respect to particular patients or special clinical situations and are not a substitute for physicianpatient consultation. Accordingly, the Brain Trauma Foundation, American Association of Neurological Surgeons, and Congress of Neurological Surgeons consider adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient's individual circumstances. Dr. Kochanek received funding from the Society of Critical Care Medicine (Editor-in-Chief of Pediatric Critical Care Medicine), from serving as an expert witness on cases in pediatric critical care. Drs. Carney and Totten's, Ms. Davis-O'Reilly's, and Ms. Hart's institutions received funding from Stanford University. Dr. Selden disclosed that he has stock options (current $0 value) in Cerebrotech for scientific advisory board service (this device is not clinically available and is not referenced in the work). Dr. Reuter-Rice received funding from textbook royalties and curriculum content, and she received support for article research from Robert Wood Johnson Foundation funding 2013-2016. Dr. Wainwright received funding from Sage Therapeutics. The remaining authors have disclosed that they do not have any potential conflicts of interest.