Severe traumatic brain injury in children--are the results improving?

摘要: Questions under study: Traumatic brain injury (TBI) remains an important cause of mortality and morbidity in children. Medical management is constantly being refined, thus results should improve. The aim the present study was to analyse our data recent years compare them with previous series (1978-83 1988-92). Patients methods: 51 children (1 month 16 old) severe blunt TBI treated unit from 1994 1998 were analyzed retrospectively. Severe defined by immediate loss consciousness admission Glasgow coma scale (GCS) <8. Outcome classified using outcome (GOS) 6 12 months after injury. Results: 35 patients (69%) showed a good (GOS 4 5), 14 died 1), one survived permanent vegetative state 2), another severely disabled 3) 1-3 = bad outcome, 31%). Bad associated low GCS (i.e. 3 4), fixed dilated pupils at admission, invisible basal cisterns on first computerized tomography, presence coagulopathy. Moderate intracranial hypertension also significantly related 26 pressure monitoring. Compared severity unchanged, incidence multiple consumption coagulopathy less frequent. Intubation rate prior centre increased 35% 94%. Intensive care measures (duration mechanical ventilation, use hypothermia, mannitol, thiopentone etc.) aggressive. remained unchanged (69% vs. 60%). Conclusions: Despite changing policies, comparable those former series. This fact underlines importance primary secondary role intensive final outcome.