Winitra Nuallaong, Thanya Nuallaong, Nongluck Preechadirek
Academic Achievement from Using the Learning Medium Via a Tablet Device Based on Multiple Intelligences in Grade 1 Elementary Student
Journal of the Medical Association of Thailand = Chotmaihet thangphaet
understand relationship timing initiation nutritional support children severe traumatic brain injury outcomes secondary analysis randomized controlled trial therapeutic hypothermia pediatric traumatic brain injury consortium hypothermia also known cool kids trial nct 00222742 fifteen clinical sites united states australia new zealand inclusion criteria included 1 age less 18 years 2 postresuscitation glasgow coma scale less equal 8 3 glasgow coma scale motor score less 6 4 available randomized within 6 hours injury exclusion criteria included normal head ct glasgow coma scale equals 3 hypotension greater 10 minutes fifth percentile age uncorrectable coagulopathy hypoxia arterial oxygen saturation 90 30 min pregnancy penetrating injury unavailability parent guardian consent centers without emergency waiver consent therapeutic hypothermia 3233c 48 hr followed slow rewarming primary study analysis intervention extraction data regarding nutritional support existing database timing initiation nutritional support determined patients stratified four groups group 1no nutritional support first 7 group 2nutritional support initiated 48 hr injury group 3nutritional support initiated 48 72 hr injury group 4nutritional support initiated 72168 hr injury outcomes also stratified mortality glasgow outcomes scaleextended pediatrics 14 57 8 6 12 months mixedeffects models performed define relationship nutrition outcome children n 90 77 randomized 13 runin enrolled mean glasgow coma scale 58 mortality rate 133 578 subjects received hypothermia initiation nutrition 72 hours associated survival p 001 favorable 6 months glasgow outcomes scaleextended pediatrics p 003 favorable 12 months glasgow outcomes scaleextended pediatrics p 004 specifically groups 2 3 favorable outcomes versus group 1 initiation nutritional support 72 hours traumatic brain injury associated decreased mortality favorable outcome secondary analysis although provides rationale initiate nutritional support early traumatic brain injury definitive studies control important covariates severity injury clinical site calories delivered parenteralenteral routes factors needed provide definitive evidence optimization timing nutritional support severe traumatic brain injury children