Intracranial pressure and cerebrovascular autoregulation in pediatric critical illness

Area of Science:

• Pediatric intensive care
• Neurocritical care
• Pediatric neurology

Background:

• Protecting the brain is crucial in critically ill infants and children with brain involvement.
• Illness-induced derangements in intracranial pressure, circulatory homeostasis, and pressure autoregulation are central to management.
• Understanding these physiological derangements is fundamental for effective bedside care.

Purpose of the Study:

• To provide an understanding of key physiological derangements affecting the brain in critically ill children.
• To outline a physiological approach to bedside care and monitoring for neuroprotection.
• To enhance the management of pediatric patients with critical brain illness.

Main Methods:

• This is a review article, synthesizing existing knowledge.
• Focuses on physiological principles relevant to bedside care.
• Integrates concepts of intracranial pressure, circulatory homeostasis, and autoregulation.

Main Results:

• Key physiological derangements impacting brain protection are identified.
• A framework for physiological bedside management is presented.
• Highlights the importance of monitoring intracranial pressure, circulation, and autoregulation.

Conclusions:

• A thorough understanding of intracranial pressure, circulatory homeostasis, and autoregulation is essential for neuroprotection in pediatric critical illness.
• A physiological approach to bedside management and monitoring is vital for vulnerable infants and children.
• This review aids clinicians in optimizing neurocritical care for pediatric patients.