This multicenter study, in which our institution actively participated, provides the first evidence that specific thresholds of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) are independently associated with long-term outcomes in children with traumatic brain injury (TBI).

The results indicate that maintaining CPP within a defined optimal range— particularly between 56 and 89 mmHg —is associated with improved neurological recovery. Importantly, the lower threshold identified in this study exceeds the current guideline recommendations, suggesting that existing pediatric CPP targets may require revision to avoid suboptimal outcomes.

These findings underscore the critical importance of individualized, evidence-based hemodynamic management in pediatric TBI, particularly with regard to continuous monitoring and control of CPP to mitigate secondary brain injury and enhance long-term recovery.

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