Neuroanesthesia & neurocritical care
Results of the Pediatric Guideline Adherence and Outcomes (PEGASUS) Program Versus Usual Care Pragmatic Randomized Controlled Trial in Severe Traumatic Brain Injury
Authors' conclusion
Implementing an evidence-based TBI program was not superior to usual care in increasing first 3-day cumulative ICU TBI guideline adherence rates in all children with severe TBI. However, implementation increased adherence rates in children with isolated severe TBI.
Study context
- Population
- Children <18 years with severe traumatic brain injury (TBI) (GCS ≤ 8 or, if intubated, motor GCS ≤ 5) admitted to ICU, 16 South American hospitals
- Participants
- 389 children · 16 hospitals
- Comparison
- PEGASUS program vs usual care
- PEGASUSn = 181
- Usual caren = 208reference
- Primary endpoint
- Cumulative ICU TBI guideline adherence rate, all and stratified by extracranial injury
- Follow-up
- First 3 days
Methodological detailsopen-label, pragmatic, multicentre, phase 3, superiority, parallel cluster, 16 South American hospitals (14 Argentina, 1 Chile, 1 Paraguay)
- Open-label
- Pragmatic
- Multicentre
- Phase 3
- Superiority
- Parallel cluster
- 16 South American hospitals (14 Argentina, 1 Chile, 1 Paraguay)
Primary result
As reported in the abstract
First 3-day cumulative ICU TBI guideline adherence rate, all patients
Further findings
| Outcome | Percent difference (CI) | P value | |
|---|---|---|---|
| Guideline adherence rate, isolated severe TBI (subgroup) · first 3 daysIntervention vs Control · higher adherence at intervention sites | 7.9% (1.9–13.8%) | P = 0.01 | |
| −1001020Difference (linear scale) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Results of the Pediatric Guideline Adherence and Outcomes (PEGASUS) Program Versus Usual Care Pragmatic Randomized Controlled Trial in Severe Traumatic Brain Injury. Crit Care Med. Published 27 March 2026. doi:10.
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