Neuromonitoring in Children with Traumatic Brain Injury

TL;DR

This review discusses tools for monitoring brain function in children with traumatic brain injury to improve treatment and outcomes.

Contribution

The paper reviews current and future neuromonitoring techniques for individualized treatment in pediatric traumatic brain injury.

Findings

Current guidelines use fixed targets for intracranial and cerebral perfusion pressure in children.

Advanced neuromonitoring tools may help individualize treatment based on cerebral physiology.

Understanding pathophysiology through monitoring is key to improving outcomes in pediatric TBI.

Abstract

Traumatic brain injury remains a major cause of mortality and morbidity in children across the world. Current management based on international guidelines focuses on a fixed therapeutic target of less than 20 mm Hg for managing intracranial pressure and 40–50 mm Hg for cerebral perfusion pressure across the pediatric age group. To improve outcome from this complex disease, it is essential to understand the pathophysiological mechanisms responsible for disease evolution by using different monitoring tools. In this narrative review, we discuss the neuromonitoring tools available for use to help guide management of severe traumatic brain injury in children and some of the techniques that can in future help with individualizing treatment targets based on advanced cerebral physiology monitoring.

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