Major traumatic brain injury is a huge issue for Paediatric Intensive Care. We have machines for almost every organ: but the brain is on its own.



Shruti Agrawal, consultant in paediatric intensive care in Addenbrookes Hospital, Cambridge, is first author on the Starship study, recently published in the Lancet eClinical medicine.



We discussed this study with her. 135 children with severe traumatic brain injury were studied with over 17,000 hours of data analysed.



PRx: what is it, what does it mean, how do we derive it, and what implications does it have? What is the optimal cerebral perfusion pressure (CPPopt), what intracranial pressure should we be targeting, and how do we know what is best for the individual patient?



Does NIRS, or TCD have a role? Which of these are proxy measures, and at how many degrees of separation?



This is a really difficult area to treat, but high quality studies like this are really important to improve our knowledge.



And just for the record, the alpha is 0.05, not 0.5. Phew.