alexa Moving Forward: The Role of Neuromonitoring in Pediatric Traumatic Brain Injury and Targeted Therapy | Open Access Journals
ISSN: 2572-0775
Clinical Pediatrics: Open Access
Like us on:
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Moving Forward: The Role of Neuromonitoring in Pediatric Traumatic Brain Injury and Targeted Therapy

Luis Rafael Moscote-Salazar1* and Guru Dutta Satyarthee2

1Neurosurgeon-Critical Care, RED LATINO Organización latinoamericana de Trauma y Cuidado neurointensivo, Bogota, Chile

2Associate Professor, Department of Neurosurgery, Neuroscience centre, All India Institute Of Medical Sciences, New Delhi, India

*Corresponding Author:
Luis Rafael Moscote-Salazar
Neuro surgeon, Red Latino
Latin American Trauma & Intensive Neuro-Care Organization, Chile
Tel: +57301283538
E-mail: [email protected]

Received Date: December 10, 2015 Accepted Date: December 11, 2015 Published Date: January 05, 2016

Citation:Moscote-Salazar LR, Satyarthee GD (2016) Moving Forward: The Role of Neuromonitoring in Pediatric Traumatic Brain Injury and Targeted Therapy. Clin Pediatr 1: e103. doi: 10.4172/2572-0775.1000e103

Copyright: © 2016 Moscote-Salazar LR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Clinical Pediatrics: Open Access

Editorial

Traumatic brain injury is a major cause of morbidity and mortality in the developed counytry. The main purpose of patients care in the intensive care unit is to prevent development of secondary brain injury and its treatment. The neuroprotection comprising of several strategies constitute the backbone of management including maintainance of adequate cerebral perfusion pressure sufficient to meet the metabolic demands for oxygen and glucose [1]. Traumatic brain injury is also a leading cause of death in children. Neurointensive pediatric management is currently in its infancy unlike well-developed research based supporting understanding in adult population. The adult based application protocol using targeted therapy for monitoring and control of intracranial pressure (ICP) based on cerebral perfusion pressure (PPC) does not totally prevent the development of cerebral hypoxia or ischemic injury [2,3].

The intracranial pressure control provides a way to control the secondary injury. The rise of ICP increases risk of secondary brain injury by affecting cerebral blood flow, which leads to tissue ischemia. The duration of the sustained rise of the IPC is directly related to the subsequent worse neurological prognosis of TBI, however, not all cases with intracranial hypertension has a poor prognosis, as this is highly relevant in the pediatric population as it shows ICP and CPP monitoring are not the sole derterminant of prognostic outcome puzzle game [4].

Brain tissue oxygen stress (PbtO2) monitoring can be a useful alternative, but currently there is only one level III recommendation to maintain PbtO2>10 mm Hg. On the other hand the Jugular venous saturation monitoring (SjvO2) helps us measuring the balance between the cerebral oxygen supply and demand. The evaluation of SjvO2 technique is remarkably useful but real limiatation is lack of existence of management- protocols for optimal implementation in the pediatric age-group [5,6].

Cerebral Microdialysis, Transcranial Doppler Ultrasonography are also used in centers worldwide for continuous monitoring, however the microdialysis failed to demonstrated benefit specially in the pediatric traumatic brain injury, Transcranial doppler will be useful for evaluation of cerebral vascular autoregulation , but more detailed research evaulation is necessary prior to conclude typical role of the alteration of cerebro-vascular auto-regulation as independent poor neurological prognosis factor in infants [7-9].

The neuromonitoring in TBI has its advantages and limitations. The complex data acquired during the use of these techniques in the of pediatric traumatic brain injury management can aid to improve the neurological outcome. In the recent future, integration of various modes of neuromonitoring will be method of choice in the pediatric traumatic brain injury configured to set a new trend of personalized management.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Recommended Conferences

Article Usage

  • Total views: 7828
  • [From(publication date):
    April-2016 - Jul 21, 2017]
  • Breakdown by view type
  • HTML page views : 7783
  • PDF downloads :45
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords