Observational studyCritical care (London, England)2025
The value of dynamic cerebral compliance monitoring after pediatric traumatic brain injury: a STARSHIP study sub-analysis.
Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Future Directions and Evolution Strategies for the Clinical Management of Traumatic Brain Injury.Journal of clinical medicine · 2026Article
- Waveform-Derived Metrics of Intracranial Compliance: Validation and Pulsatile Dynamics.Neurocritical care · 2026Article
- Cerebrospinal fluid dysregulation and post-traumatic hydrocephalus after paediatric traumatic brain injury.Frontiers in neurologyReview
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
introductionCerebral compliance describes the pressure-volume relationship within the intracranial space, quantifying the brain's capacity to accommodate changes in volume before significant increases in intracranial pressure (ICP) occur. The pulse shape index - PSI-classifies the ICP pulse-wave-configuration into 4 categories representing the incremental state of compliance. In this analysis we explore the metric in a cohort of prospectively collected pediatric TBI patients in relation to outcome, physiological parameters, and individual ICP insults. METHODOLOGY: Data acquired by the prospective observational STARSHIP study which included clinical information, 12-month outcome, and monitoring data from 98 pediatric TBI patients admitted to 10 pediatric intensive care units across the UK was assessed. PSI was calculated and compared using univariable and multivariable analyses, as well as considering their time-trends and relation to individual ICP insults.
resultsPSI derived metrics were associated with outcomes within univariable analyses, additionally they were associated with ICP, and worse cerebrovascular reactivity (absolute correlation coefficients close to 0.3 for the described metrics). Cross correlation analysis revealed a median delay of 8 min for changes in ICP after changes in PSI (95% confidence interval of 7.6 to 8.5 min). Higher PSI value before ICP elevations was associated with longer duration and greater magnitude of subsequent ICP insults. Additionally, higher PSI before and faster decrease in PSI after osmotherapy were associated with successful reduction of ICP.
conclusionsPSI enhances bedside monitoring of pediatric TBI by enabling dynamic assessment of cerebral compliance. Variations in PSI appear to precede subsequent ICP insults and are associated with their severity, thereby potentially facilitating timely interventions. Furthermore, assessing the PSI level before administering osmotherapy may allow gauging treatment success.
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