Neuroprotection in traumatic brain injury

Traumatic brain injury is the leading cause of trauma-related death and disability in children worldwide. To improve neuro-outcomes after injury, neuroprotective measures are implemented to limit secondary brain injury by providing adequate cerebral perfusion and oxygenation. In this article we review the general supportive and targeted neuroprotective measures that are outlined in the international paediatric guidelines and the physiological basis for these recommendations based on the underlying pathology. We also discuss multimodal neuro-monitoring in the PICU. We aim to provide a practical approach on how to respond to deteriorating patients, and manage complications arising during the course of their treatment.