Author: sarah.rastrick@act4addenbrookes.org.uk

Traumatic brain injury is the leading cause of death and disability in children worldwide and more than two thirds of the survivors suffer longer term problems.

The most severely injured are managed by monitoring blood and brain pressure to set treatment targets – with the potential to improve outcomes by individualising targets via real-time analysis of routinely collected data.

This system of monitoring is known as ‘continuous assessment of cerebrovascular autoregulation (CA) using pressure reactivity index (PRx).”

Prior to the STARSHIP study, data collection for cerebrovascular autoregulation monitoring in paediatric traumatic brain injury was limited to single-centre studies, or looking back at past events, suggesting the data may be ‘inadequate.’

However, the study, led by Dr Shruti Agrawal (R), a paediatric intensivist and paediatric trauma lead at Cambridge University Hospitals, collected data from 10 UK Paediatric Intensive Care Units (PICUs) over five years and focused on 135 children under 16 years old and a multitude of factors associated with favourable outcomes, unfavourable outcomes and deaths. The aim was to identify critical thresholds of PRx in relation to outcome and create a research database.

The study findings support PRx monitoring in paediatric traumatic brain injury which could be used to fine-tune treatment targets with the potential of improving outcomes in this vulnerable group of patients. The improved data resource will ultimately be opened to third-party investigators, encouraging continued research and collaboration to help improve understanding and outcome for paediatric traumatic brain injury.

Dr Agrawal said: “Understanding the underpinning principles and management of raised intracranial pressure and brain perfusion is essential for reducing the morbidity and mortality of traumatic brain injuries.”

By extending the collection of data to multiple centres, Dr Agrawal said the STARSHIP database offers ‘a unique opportunity of ongoing research and data collection.”

Helping the study were departments within the University of Cambridge; Cambridge and Peterborough NHS Foundation Trust; Birmingham Children’s Hospital; Great Ormond Street Hospital; Leeds Children’s Hospital; Manchester Children’s Hospital; Nottingham Children’s Hospital; Oxford University Hospitals; Royal London Hospital; Sheffield Children’s Hospital and Southampton Children’s Hospital.

The study was funded by Action Medical Research for Children and Addenbrooke’s Charitable Trust (ACT), sponsored by Cambridge University Hospitals NHS Foundation Trust, and supported by the National Institute of Health Research (NIHR) Cambridge Biomedical Research Centre and the NIHR Clinical Research Network.

Shelly Thake, Chief Executive at ACT, said: “We were delighted to be able to help fund this important study, which was only possible thanks to the generosity of our incredible supporters, some of whom will unfortunately have direct experience of the challenges associated with traumatic brain injury in children.”

Dr Caroline Johnston, senior research manager, Action Medical Research, added: “Funding research to further our understanding of traumatic brain injury and the long-term consequences is important and brings hope to children and their families. We are delighted to have partnered with Addenbrooke’s Charitable Trust to work towards improving the understanding and treatment of severe traumatic brain injuries in children.”

Mia Jack, 18, from Soham was one of 135 children who joined the Starship study and applauded the research and those helping her, saying: “Anything that helps with traumatic brain injury in children – and raises awareness of it at the same time – has got to be a good thing.”

Mia was thrown over the handlebars of a quadbike, and hit a tree headfirst, during a family activity day when she was 12 and put into an induced coma at the scene before being airlifted to Addenbrooke’s. Part of her skull was removed to relieve pressure on her brain in an operation called a craniectomy, but immediately after she needed more surgery to remove a blood clot.

Music-loving Mia, who lives in with sister Isabella Jack,19, mum Angela Paine and her partner Stuart Jack, woke up when she heard a ukulele being played on the ward.

To Angela’s dismay Mia didn’t recognise her and could not walk or talk. But over several difficult weeks, Mia’s determination along with the help of specialists, meant she was finally well enough for the next stage.

After a brief rest at home, she went to The Children’s Trust in Surrey – a charity -which offered a two-month rehabilitation programme involving physiotherapy, speech and language therapy, occupational therapy and hydrotherapy.

As she continued her recovery, Mia would play the piano in the common room. She later returned to Addenbrooke’s to have a titanium plate fitted over the hole in her skull, during which she says David Guetta’s hit ‘Titanium’ became something of a “personal anthem” – and part of her piano playing repertoire.

Cambridge Centre for Paediatric Neuropsychological Rehabilitation offered Mia support over three months, including counselling. It helped her overcome the inevitable low moments, which was also helpful to the family.

The teenager was relieved to return to school and successfully moved up to Cambridge Regional College where she is in her second year of a hairdressing course.

She continues to sing, play the piano, and loves dancing, gymnastics and acting. She hopes to undertake a performing arts course next year and has discovered a talent for poetry.

Mum Angela, who works in catering but is also studying hairdressing, said: “To me Mia’s recovery has been nothing less than a miracle. She is so courageous, so talented, and I am very proud of all she achieves.”

Mia said: “When I woke after the accident I was completely confused and didn’t know who mum was, what had happened, and I didn’t understand what was going on. I was wearing a helmet at the time, but apparently my brain was like a jelly in a box that had been really badly shaken and I was going to be in hospital for some time.”

“To say it was all a bit of a struggle would be an understatement, but I am a fighter and hope someone else can take inspiration from that.

Click here to find out what happens for patients at Addenbrooke’s when supporters help us invest in research.

A team of highly-skilled robotic surgeons and clinical staff has carried out a record number of gallbladder operations in a single day using high-tech robots that assist with keyhole surgery. 

Yesterday’s ‘Super Sunday’ saw surgeons undertake ten laparoscopic procedures with all patients treated and discharged the same day, with robotic surgery allowing this to happen because of faster recovery times. 

Sunday’s marathon focussed on cholecystectomies – a surgical procedure to remove the gallbladder and offered in the event of painful gallstones in the upper part of the stomach. The pouch-like gallbladder is not medically essential.  

Hepatobiliary Surgeon Mr Siong-Seng Liau, (right) Chair of CUH Robotic Surgery Steering Group (RUG) at Addenbrooke’s, said Super Sunday was a first for the hospital. 

He thanked Addenbrooke’s Charitable Trust, the official charity for Addenbrooke’s and the Rosie, and said the day had been made possible thanks to the generous donations of ACT supporters who raised a staggering £1.5 million to provide Addenbrooke’s with the new da Vinci Robotic System back in 2023. 

By undertaking the same procedures in two theatres with two specialist da Vinci robots, specially trained surgeons can perform a large number of these operations safely and efficiently, helping reduce waiting lists. Many of the patients who developed more complex gallbladder disease had benefited from the faster recovery provided by robotic surgery.  

Addenbrooke’s robots are used across six specialties – urology, gynae-oncology, gynaecology, colorectal, ENT (ear, nose and throat) and HPB (hepato-pancreato-biliary – diseases of the liver, pancreas and biliary tree). 

Mr Liau said: “Robotic surgery has revolutionised patient care, providing better precision and accuracy. It is less invasive allowing patients to recover more quickly and to have a shorter stay in hospital. In many cases, robotic surgery has converted some patients who conventionally may require open surgery due to more complex disease to now undergoing day-case robotic surgery.”  

ACT CEO, Shelly Thake, (left) said: “It is important for everyone who has helped make this day possible by donating to ACT as part of the robot campaign to realise the huge impact their fundraising and donations have had.” 

“To hear that the robotic surgery system that our supporters paid for is helping to reduce waiting list for patients is such a positive thing for the hospitals and our patients.  I truly hope people know that every donation they make to ACT really does make a huge difference to the lives of patients and staff at the hospital and we are so incredibly grateful.” 

Graham Johnston, Operations manager at CUH, added: “I would like to thank the robotic team for an incredibly successful Sunday, and everyone who works in theatres for an amazing couple of months. It has been a huge team effort during a really challenging time of year.” 

To make a donation to ACT, and help make a difference to the lives of patients and families in the hospital, please visit www.act4addenbrookes.org.uk/donate.  

Patient Ian Dove applauds Super Sunday team 

A great grandfather who had his gallbladder removed thanks to a robot and skilled surgeon Mr Siong-Seng Liau, said this week: “It was just remarkable.” 

Ian Dove, 51, (pictured right) from Burwell, says he went into theatre at noon and left Addenbrooke’s at 3.30pm the same day. Had he undergone open surgery he would have been in hospital for a week. 

“The incredible thing is that I left without any pain. I think keyhole surgery and Super Sundays to cut waiting lists are a fantastic idea.” 

Mr Dove, who works in construction, went to his GP when he started suffering from pain in his upper stomach. The pain came and went, but when it became constant, he was referred to Addenbrooke’s. 

After a lengthy wait for his operation Mr Dove, who was increasingly having to take days off work, jumped at the opportunity to be added to a smaller pilot Super Sunday list in December. 

After a few weeks recovering at home Mr Dove, who has 13 grandchildren and four great grandchildren, is looking forward to spending more time with them. 

He is also eager to get back to some fishing and his beloved 600cc Suzuki Bandit for a long-awaited ride to the Ice of Man TT motorcycle races in June. 

Mr Dove, who lives with wife Glynis said: “There were days when I couldn’t pick up a screwdriver, let alone move bricks and cement, but after the operation I was absolutely fine with the exception of a few ‘bullet holes’, which you can hardly see now.” 

ACT is thrilled that the ambitious plans for the new Cambridge Cancer Research Hospital to be housed on the Cambridge Biomedical Campus, next to Addenbrooke’s Hospital, AstraZeneca and Royal Papworth Hospital, can go ahead and is on track to be built by 2029.

The Secretary of State for Health and Social Care announced the wonderful news in the House of Commons that the specialist cancer research hospital will bring world-leading research and clinical excellence together, to change the lives of cancer patients across the East of England, UK and across the globe.

In naming the project as one of the schemes that has advanced plans in place, including significant progress on our full business case, the Government has confirmed that we can prepare for construction to start in 2026.

A programme of pre-construction works will start next month, which includes the installation of hoardings around the site of the new hospital, ground clearance works and an archaeological dig.

Cambridge Cancer Research Hospital, a partnership between Cambridge University Hospitals and the University of Cambridge, will combine NHS clinical space with three new state-of-the-art research institutes that will support the ambitions set out in the government’s new NHS ten-year plan.

Bringing together world-class NHS clinicians with cutting-edge University and industry-led research, this new hospital will accelerate the early detection of cancer and lead the way globally in delivering bespoke, precision treatments.

Cambridge Cancer Research Hospital is a partnership between Cambridge University Hospitals and the University of Cambridge. It will combine NHS clinical space with three new state-of-the-art research institutes.

Shelly Thake, Chief Executive of Addenbrooke’s Charitable Trust, said:

“Today’s news that the Government has voted to forge ahead with plans for the new Cambridge Cancer Research Hospital is fantastic news for everyone – the community of Cambridge and beyond; patients, families and staff within the East of England as well as patients and families nationally and globally too, all of whom will get to benefit from the ground-breaking research and work that will come out of this amazing new hospital.”

“Our fundraising campaign is underway with lots more opportunities to come.  I would like to praise the continued passion, hard work and dedication of all our supporters and fundraisers – all of whom continue to give so much and who I know will continue to do so until we see this pioneering new hospital built.”

Additional fundraising and philanthropy will still be required to realise our vision for the new NHS hospital, as has always been the case, but this news gives us – and those interested in supporting this campaign – the confidence to do whatever it takes and change the story of cancer forever.

To find out how you can get involved in fundraising for the new Cambridge Cancer Research Hospital, or to make a donation to support this campaign, please click here.