158 HYPERVENTILATION IN SEVERE PEDIATRIC TRAUMATIC BRAIN INJURY BEFORE AND AFTER 2003 BRAIN TRAUMA FOUNDATION GUIDELINES.

Background In 2003, the Brain Trauma Foundation (BTF) issued guidelines that severe hyperventilation (SHV, PaCO2 Methods Electronic medical records at the Harborview Medical Center at University of Washington were reviewed retrospectively for all severe pTBI injuries in children Results The pre-BTF group included 375 patients and the post-BTF group included 89 patients. There was no difference in the PaCO2 sampling frequency (7.1 vs 8.4 PaCO2 samples in 48 hours). SHV was common during both periods, and no difference was found between pre- and post-BTF (59.7% vs 51.7%). However, SHV incidence decreased over successive years (1995-2005). The majority of SHV occurred during the first 2 hours after hospital admission. In SHV episodes with preceding recorded ICP measurements, the majority (62/81) occurred with ICP Conclusions SHV was common during the first 48 hours after hospital admission. There was no decrease in SHV pre- and post-BTF. SHV predicted mortality.