Neuroanesthesia & neurocritical care
Visualizations of autoregulatory insults in moderate-to-severe paediatric traumatic brain injury: a secondary analysis from the multicentre STARSHIP trial
Authors' conclusion
This novel study visualized the safe and dangerous intervals for PRx and CPPopt as well as the interaction effect between the autoregulatory status and ICP, CPP, and ΔCPPopt in relation to outcome in paediatric TBI.
Study context
- Population
- Paediatric traumatic brain injury (TBI) patients (1–16 years), 10 UK PICUs, 2018–2023, with high-frequency physiological data and 12-month GOS-E Peds outcomes, not treated with decompressive craniectomy
- Participants
- 98 patients · 10 PICUs
- Primary endpoint
- Association of ICP, PRx, CPP and ΔCPPopt insults with outcome (GOS-E Peds)
- Follow-up
- 12 months
Methodological detailsinsult intensity/duration heatmaps
- Insult intensity/duration heatmaps
Primary result
As reported in the abstract
Insult intensity/duration vs outcome
- Transition from favourable to unfavourable outcome when PRx exceeded + 0.00 for longer episodes
- Transition towards worse outcome when cerebral perfusion pressure (CPP) below 40 mmHg and above 100 mmHg for sustained durations
- Transition towards poor prognosis for ΔCPPopt below - 20 mmHg; positive ΔCPPopt tolerated
Further findings
Two-variable heatmaps incorporating PRx
- PRx above + 0.50 together with intracranial pressure (ICP) above 20 mmHg, CPP below 60 mmHg, or negative ΔCPPopt particularly associated with unfavourable outcome
Original publication
Visualizations of autoregulatory insults in moderate-to-severe paediatric traumatic brain injury: a secondary analysis from the multicentre STARSHIP trial. Crit Care. Published 4 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →