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KidsBrainIT: A New Multi-centre, Multi-disciplinary, Multi-national Paediatric Brain Monitoring Collaboration.

T Lo1, I Piper2, B Depreitere3

  • 1Royal Hospital for Sick Children, Edinburgh, UK.

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|March 2, 2018
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Summary
This summary is machine-generated.

Establishing optimal cerebral perfusion pressure (CPPopt) thresholds is crucial for managing pediatric traumatic brain injury (TBI). The KidsBrainIT collaboration aims to collect data to determine these vital CPPopt levels for improved pediatric intensive care unit (PICU) management.

Keywords:
BrainITInformaticsNeurointensive carePaediatric brain injury

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Area of Science:

  • Pediatric intensive care
  • Neuroscience
  • Traumatic brain injury management

Background:

  • Optimal cerebral perfusion pressure (CPP) treatment thresholds for children with traumatic brain injury (TBI) are not established.
  • Current intensive care unit (ICU) management of pediatric TBI lacks validated CPP targets.
  • There is a critical need for a standardized approach to assess autoregulation and determine optimal CPP (CPPopt) in pediatric TBI patients.

Purpose of the Study:

  • To establish a new multi-center pediatric collaboration, KidsBrainIT, for collecting standardized ICU data.
  • To develop and implement models for assessing cerebral autoregulation and determining CPPopt in pediatric TBI.
  • To facilitate a prospective validation study for CPPopt in the pediatric TBI population.

Main Methods:

  • Adapting the adult BrainIT group's methodology for pediatric application.
  • Establishing a data repository for prospectively collected high-resolution physiological, clinical, and outcome data from multiple pediatric intensive care units (PICUs).
  • Collaborating with the Leuven Group for autoregulation assessment (LAx, DATACAR) and utilizing diffuse optical monitoring and tomography technology for perfusion assessment.

Main Results:

  • Pilot analyses in two centers demonstrate that CPPopt varies over time for individual patients.
  • Median CPPopt levels were identified for different pediatric age groups (2-6 years: 68.83 mmHg, 7-11 years: 68.09 mmHg, 12-16 years: 72.17 mmHg).
  • Survivors with favorable outcomes showed a significantly higher proportion of time monitored within CPPopt (p = 0.04 and p = 0.01).

Conclusions:

  • A multi-center PICU collaboration is necessary and of interest for acquiring data to determine validated CPPopt thresholds in pediatric TBI.
  • The KidsBrainIT initiative is being formed to address the need for establishing CPPopt in pediatric TBI management.
  • These findings support the rationale for a prospective validation study of CPPopt in children.