| Autor: |
Adam M H, Young, Joseph, Donnelly, Xiuyun, Liu, Mathew R, Guilfoyle, Melvin, Carew, Manuel, Cabeleira, Danilo, Cardim, Matthew R, Garnett, Helen M, Fernandes, Christina, Haubrich, Peter, Smielewski, Marek, Czosnyka, Peter J, Hutchinson, Shruti, Agrawal |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Acta neurochirurgica. Supplement. 126 |
| ISSN: |
0065-1419 |
| Popis: |
Although secondary insults such as raised intracranial pressure (ICP) or cardiovascular compromise strongly contribute to morbidity, a growing interest can be noticed in how the pre-hospital management can affect outcomes after traumatic brain injury (TBI). The objective of this study was to determine whether pre-hospital co-morbidity has influence on patterns of continuously measured waveforms of intracranial physiology after paediatric TBI.Thirty-nine patients (mean age, 10 years; range, 0.5-15) admitted between 2002 and 2015 were used for the current analysis. Pre-hospital motor score, pupil reactivity, pre-hospital hypoxia (SpOThose with pre-hospital hypotension were susceptible to higher ICP [20 (IQR 8) vs 13 (IQR 6) mmHg; p = 0.01] and more frequent ICP plateau waves [median = 0 (IQR 1), median = 4 (IQR 9); p = 0.001], despite having similar MAP, CPP and PRx during monitoring. Those with unreactive pupils tended to have higher ICP than those with reactive pupils (18 vs 14 mmHg, p = 0.08). Pre-hospital hypoxia, motor score and pupillary reactivity were not related to subsequent monitored intracranial or systemic physiology.In paediatric TBI, pre-hospital hypotension is associated with increased ICP in the intensive care unit. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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