Traumatic brain injury (TBI) is a major cause of death and disability in children. Most of the therapies available in TBI management focus on management of intracranial pressure in a tiered fashion. Liao et al used a novel technique in TBI management, infusing autologous bone marrow-derived mononuclear cells (BMMNCs). Using data obtained from a phase 1 trial published in 2011, the authors compared the therapeutic intensity needed to prevent intracranial hypertension in 10 pediatric patients who received infusions of BMMNCs between 2006 and 2008 versus 19 control patients who were admitted with TBI between 2000 to 2008. The authors employed the Pediatric Intensity Level of Therapy (PILOT) scoring system, a validated tool used to identify therapeutic intensity.
They found that PILOT scores were significantly lower in the treatment group compared to the control group, starting at 24 hours posttreatment and lasting through the first week. Liao and colleagues should be applauded for pursuing this unconventional and novel approach to TBI management. However, more work needs to be done—perhaps in a multicenter trial—before this therapy is applied.
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