Kochar A, Hildebrandt K, Silverstein R, Appavu B. Approaches to neuroprotection in pediatric neurocritical care. World J Crit Care Med 2023; 12(3): 116-129 [PMID: 37397588 DOI: 10.5492/wjccm.v12.i3.116]
Corresponding Author of This Article
Brian Appavu, MD, Assistant Professor, Department of Neurosciences, Phoenix Children's Hospital, 1919 E. Thomas Road, Ambulatory Building B, 4th Floor, Phoenix, AZ 85016, United States. bappavu@phoenixchildrens.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Jun 9, 2023; 12(3): 116-129 Published online Jun 9, 2023. doi: 10.5492/wjccm.v12.i3.116
Approaches to neuroprotection in pediatric neurocritical care
Angad Kochar, Kara Hildebrandt, Rebecca Silverstein, Brian Appavu
Angad Kochar, Kara Hildebrandt, Rebecca Silverstein, Brian Appavu, Department of Neurosciences, Phoenix Children's Hospital, Phoenix, AZ 85213, United States
Brian Appavu, Child Health, University of Arizona College of Medicine - Phoenix, Phoenix, AZ 85016, United States
Author contributions: Kochar A, Hildebrandt K, Silverstein R and Appavu B contributed to the conception of this review, analysis of the data, and writing of the manuscript, and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Brian Appavu, MD, Assistant Professor, Department of Neurosciences, Phoenix Children's Hospital, 1919 E. Thomas Road, Ambulatory Building B, 4th Floor, Phoenix, AZ 85016, United States. bappavu@phoenixchildrens.com
Received: December 28, 2022 Peer-review started: December 28, 2022 First decision: March 1, 2023 Revised: March 30, 2023 Accepted: April 12, 2023 Article in press: April 12, 2023 Published online: June 9, 2023 Processing time: 162 Days and 5.5 Hours
Abstract
Acute neurologic injuries represent a common cause of morbidity and mortality in children presenting to the pediatric intensive care unit. After primary neurologic insults, there may be cerebral brain tissue that remains at risk of secondary insults, which can lead to worsening neurologic injury and unfavorable outcomes. A fundamental goal of pediatric neurocritical care is to mitigate the impact of secondary neurologic injury and improve neurologic outcomes for critically ill children. This review describes the physiologic framework by which strategies in pediatric neurocritical care are designed to reduce the impact of secondary brain injury and improve functional outcomes. Here, we present current and emerging strategies for optimizing neuroprotective strategies in critically ill children.
Core Tip: Acute neurologic injuries are a common cause of morbidity and mortality in critically ill children. A fundamental goal of pediatric neurocritical care is to mitigate the impact of secondary neurologic injury in critically ill children. Here, we discuss strategies for optimizing neuroprotective strategies in critically ill children.
