Annales francaises d'anesthesie et de reanimation · 1998
[-Secondary cerebral stress of systemic origin in children with severe craniocerebral injuries-].
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Marescal C, Adnet P, Bello N, Halle I, Forget A P, Boittiaux P
Аннотация
OBJECTIVE: To assess incidence of secondary brain insults of systemic origin (SBISOs) such as arterial hypotension, hypoxaemia, hypercarbia, and anaemia in severely head injured children; to assess their impact on mortality and morbidity in the short- and long-term.
STUDY DESIGN: Prospective, open study covering a 24-month period.
PATIENTS: Seventy-one children, under 15 years of age, admitted to a trauma centre for severe brain injury.
METHOD: Analysis of SBISOs and outcome.
RESULTS: Twenty-five children were admitted with SBISOs. The mortality rate was 37%. After hospitalization, 84% of the children with SBISOs vs 46% without SBISOs had severe disability (Glasgow outcome score = 1, 2 and 3). After 1 year, 20 out of the 45 children still alive were contacted. One of the four with SBISOs communicated a bad recovery. Fifteen children without SBISOs presented good recovery: GOS = 4-5, paediatric overall performance category (POPC scale) = 1-2.
CONCLUSION: Hypotension was associated with significant increase in mortality (x 3.6) in children with severe head injury. The consequences were worse when anaemia was associated.
STUDY DESIGN: Prospective, open study covering a 24-month period.
PATIENTS: Seventy-one children, under 15 years of age, admitted to a trauma centre for severe brain injury.
METHOD: Analysis of SBISOs and outcome.
RESULTS: Twenty-five children were admitted with SBISOs. The mortality rate was 37%. After hospitalization, 84% of the children with SBISOs vs 46% without SBISOs had severe disability (Glasgow outcome score = 1, 2 and 3). After 1 year, 20 out of the 45 children still alive were contacted. One of the four with SBISOs communicated a bad recovery. Fifteen children without SBISOs presented good recovery: GOS = 4-5, paediatric overall performance category (POPC scale) = 1-2.
CONCLUSION: Hypotension was associated with significant increase in mortality (x 3.6) in children with severe head injury. The consequences were worse when anaemia was associated.