Department of Paediatric Intensive Care, Cambridge University Hospitals National Health Service Foundation Trust, Level 3, Box 7, Addenbrookes Hospital Hills Road, Cambridge, UK.
University of Cambridge, Cambridge, UK.
Neurocrit Care. 2024 Feb;40(1):147-158. doi: 10.1007/s12028-023-01779-1. Epub 2023 Jun 29.
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.
创伤性脑损伤仍然是全世界儿童死亡和发病的主要原因。目前基于国际指南的管理方法侧重于颅内压管理的固定治疗目标,即低于 20mmHg,脑灌注压管理的目标为 40-50mmHg,适用于儿科年龄组。为了改善这种复杂疾病的预后,必须使用不同的监测工具来了解导致疾病进展的病理生理机制。在这篇叙述性综述中,我们讨论了用于帮助指导儿童严重创伤性脑损伤管理的神经监测工具,以及一些未来可能有助于基于高级脑生理监测实现个体化治疗目标的技术。