PCCM Publishes New Study by Former T32 Fellow Dr. Steven Shein


A new study lead by former Safar Center T32 Fellow Dr. Steven Shein was recently published in the journal Pediatric Critical Care Medicine. The article, titled “Effectiveness of Pharmacological Hypertension in Children with Severe Traumatic Brain Injury (TBI)—Results From an Automated Data Collection System Time-Synched to Drug Administration” explored how several commonly used therapies to control of intracranial pressure (ICP) compared in efficacy in real world use.  Dr. Shein and co-workers studied 25 children with severe TBI and compared treatment with the narcotic fentanyl, the osmolar agent hypertonic saline, and the barbiturate pentobarbital on raised ICP.  The study addressed data from nearly 200 doses of these medications using an extremely granular state-of-the-art data collection system that collected ICP data every 5 seconds. The results, published in the March issue of Pediatric Critical Care Medicine, suggest that hypertonic saline was associated with the fastest improvement in ICP, and the most salutary effects on cerebral perfusion pressure (CPP). These findings may help clinicians optimize therapeutic choices to improve care of these severely injured children and also support evidence-based recommendations in future versions of the TBI Guidelines. Dr. Shein was mentored by Dr. Michael Bell on this project. Dr. Shein is currently an Assistant Professor in the Department of Pediatrics at Rainbow Babies & Children's Hospital in Cleveland, Ohio,