Use of Serum Biomarkers to Predict Secondary Insults Following Severe Traumatic Brain Injury

The management of severe traumatic brain injury (TBI) focuses on prevention and treatment of intracranial hypertension (ICH) and cerebral hypoperfusion (CH). Predicting which patients will develop these secondary insults is currently not possible. This study investigates the systemic manifestation of neuroinflammation and its role in helping to predict clinical deterioration following severe TBI. Patients with head Abbreviated Injury Severity greater than 3, age older than 14 years, "isolated" TBI, and placement of intracranial pressure monitor were prospectively enrolled. Serum was collected within 24 h and twice daily for 7 days. Measures of moderate and severe ICH (intracranial pressure >20 and >30 mmHg) and moderate and severe CH (cerebral perfusion pressure