Advanced Neuro-Monitoring in Paediatric Neurosurgery

Prof. Peter Hutchinson

A prospective study in to the use of advanced neuro­monitoring for paediatric patients with acute brain injury.

Children suffer proportionally more head injuries than any other age group and furthermore, children with severe head injuries have the highest mortality of all children admitted with traumatic injuries. Much of the brain damage that results in poor outcomes actually happens in the hours and days after the injury. This is due to several factors such as brain swelling and poor oxygen delivery to the brain. Treatment of children with severe head injuries is currently guided by monitoring pressure within the head. However, this does not detect the other, arguably more important factors, which cause continuing brain damage. Special monitors that follow oxygen levels and chemical changes in the brain are used safely in adult patients but have not been widely employed in children despite their potential benefit. There is therefore the opportunity to evaluate extra monitoring of the child brain and, in doing so, help refine our management of these patients. Data will be collected from ICP sensors that are routinely used in children with severe brain injuries. In addition, microdialysis catheters and Licox sensors, which respectively monitor brain metabolism and oxygen levels, will be used.