Pediatric anesthesia & critical care
An open source autoregulation-based neuromonitoring algorithm shows PRx and optimal CPP association with pediatric traumatic brain injury
Authors' conclusion
Our algorithm can obtain optimal targets for pediatric neuromonitoring that showed association with long-term outcome, and is now available open source.
Study context
- Population
- Children (< 18 years) with severe TBI admitted to the pediatric intensive care unit (PICU) for intracranial pressure (ICP) monitoring, 2016–2023
- Participants
- 50 children
- Exposure
- PRx and CPPopt-derived measures vs long-term outcome
- Favorablen = 35reference
- Unfavorablen = 15
- Outcome
- Association of PRx and CPPopt with unfavorable outcome (PCPC scale)
- Follow-up
- One year post-injury
Methodological detailsalgorithm development, open-source
- Algorithm development
- Open-source
Main finding
As reported in the abstract
Unfavorable outcome (PCPC 4-6)
Odds ratio (CI)P value
Mean PRx
2.49(1.38–4.50)
P < 0.001Median PRx
1.38(1.08–1.76)
P < 0.001CPPopt yield
0.95(0.92–0.97)
P < 0.001PRx thresholds 0.0, 0.20, 0.25 and 0.30
1.01(1.00–1.02)
P < 0.006- Mean CPPopt yield (% of monitoring time)
- 75.4%
Observational data: associations, not effects.
Further findings
ICP insults
- ICP insults correlated with unfavorable outcome at 20 mmHg for 7 min duration
CPP in optimal range, day one
- Association with unfavorable outcome (p = 0.029)
- 0.018
CPP in optimal range, day four
- Association with unfavorable outcome (p = 0.025)
- −0.026
Original publication
An open source autoregulation-based neuromonitoring algorithm shows PRx and optimal CPP association with pediatric traumatic brain injury. J Clin Monit Comput. Published 19 December 2024. doi:10.
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