Maintenance of cerebral perfusion pressure in moderate to severe traumatic brain injury attenuates cerebral nervous system inflammation after pediatric traumatic brain injury

We will continously record the spontaneous fluctuations of arterial blood pressure, cerebral perfusion pressure and cerebral perfusion in 20 pediatric patients diagnosed with TBi by using the combined near infrared Spectroscopy/Diffuse Correlation Spectroscopy (niRS/DCS) setup at bedside.also per standard of care, mean arterial pressure (MaP) will be recorded from an arterial line using the standard blood pressure module (Philips Helathcare, netherlands). Cerebral oxygenation will be measured using a multichannel niRS system at three cranial locations on each hemisphere. Cerebral blood flow will be measured bilaterally using two separate DCS devices. all data will be synched and analyzed for cerebral autoregulation. For the CPP, we will determine the as yet-unstudied representation and distribution of innate populations within-patient with CPP monitoring through multivariate analysis. Procedures for blood and CSF collection, processing and storage will be consistent with the nia Biospecimen Best Practices Guidelines and Children's Medical Center Dallas policies and procedures. Samples will be stored at uTSW BioRepository Core-collected daily over the course of eVD placement at time of niRS/DCF measurement to correlate immune populations within-patient with CPP monitoring. We expect 50-200ml of CSF to be drained daily from eVD. after the rate of CSF drainage is established withing the first 24 hours of eVD for each patient. We will collect 20ml CSF (if an eVD is in place) from apprpriate time window equidistant pre and post CPP measurement. PBL will be collected within this same time frame. Three measurements for each patient on day 1, 3, and 5 post traumatic brain injury.