Neuroanaesthesia & neurocritical care
Proteomic blood-based biomarkers of brain damage in traumatic brain injury: are they suitable surrogate endpoints for cerebral pressure autoregulatory-guided therapy?
Authors' conclusion
Cerebral physiological disturbances during intensive care after TBI were associated with elevated PBBM levels, with ICP showing the strongest influence and impaired CPA amplifying some PBBM responses. Associations were strongest in same-day analyses and appeared bidirectional.
Study context
- Population
- Patients with severe traumatic brain injury (TBI) with high-frequency cerebral physiological data and serial PBBM measurements during the first 7 days post-injuryCENTER-TBI cohort
- Participants
- 151 patients
- Outcome
- Temporal associations between PBBMs (GFAP, S100B, t-Tau, NfL, UCH-L1, NSE) and cerebral physiological variables (ICP, cerebral perfusion pressure (CPP), PRx, ΔCPPopt)
- Follow-up
- First seven days post-injury
Methodological detailsmulticentre, prospective data from the CENTER-TBI cohort
- Multicentre
- Prospective data from the CENTER-TBI cohort
Main finding
As reported in the abstract
- Elevated day-1 PBBM levels associated with greater cumulative burden of high intracranial pressure (ICP), impaired cerebral pressure autoregulation (CPA) (positive PRx) and negative ΔCPPopt over the subsequent 7 days
- Higher median PBBM concentrations correlated with elevated ICP and impaired CPA throughout monitoring; strongest when monitoring and PBBMs analysed from the same day
- In multivariate linear mixed effects models (LMEMs), elevated ICP and most PBBMs remained significantly associated; PRx in particular amplified this association
Observational data: associations, not effects.
Original publication
Proteomic blood-based biomarkers of brain damage in traumatic brain injury: are they suitable surrogate endpoints for cerebral pressure autoregulatory-guided therapy? Crit Care. Published 13 June 2026. doi:10.
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