Indicación del coma barbitúrico en el traumatismo craneoencefálico grave

Bárcena, Jon Pérez; Centelles, Joaquín; Milla, P. Marse; Juve, J. Ibanez

doi:10.1016/s0210-5691(02)79819-7

Cited by 5 publications

(2 citation statements)

References 38 publications

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“…No entanto, após ter observado que mais de 40% dos pacientes apresentaram HIC refratária, descartados aqueles com indicação cirúrgica por lesões com efeito de massa, o número é preocupante. A literatura reconhece que a mortalidade e a morbidade são altíssimas nos pacientes com HIC refratária 11,21 , mas admite também que medidas para o seu controle são de benefício ainda mais questionável na atualidade 11,22,23 .…”

Section: Discussionunclassified

Factors associated with intracranial hypertension in children and teenagers who suffered severe head injuries

Guerra¹,

Carvalho²,

Affonseca³

et al. 2010

J Pediatr (Rio J)

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Section: Discussionunclassified

Factors associated with intracranial hypertension in children and teenagers who suffered severe head injuries

Guerra¹,

Carvalho²,

Affonseca³

et al. 2010

J Pediatr (Rio J)

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“…11,22,23 Thus, in light of current knowledge, having children and teenagers with severe head injuries exposed to risk of more than 40 percent of developing undocumented refractory IH is unacceptable, but so is instituting aggressive treatments without their need being certain. 11 In this study, half of all patients were monitored more than 24 hours after the injury.…”

Section: Discussionmentioning

confidence: 99%

Fatores associados à hipertensão intracraniana em crianças e adolescentes vítimas de traumatismo crânio-encefálico grave

Guerra

Carvalho

Affonseca

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To analyze factors associated with intracranial hypertension in pediatric patients who suffered severe head injuries. Methods:Retrospective cohort study, with data collected from September 1998 through August 2003, including patients aged 0 to 16 who suffered severe head injuries, Glasgow score < 9, and submitted to intracranial pressure (ICP) monitoring (n = 132). Intracranial hypertension (IH) was defined as an episode of ICP > 20 mmHg requiring treatment, while refractory IH was ICP over 25 mmHg requiring barbiturates or decompressive craniectomy. Univariate analysis was followed by multivariate analysis; variables were considered significant if p < 0.05. Results:Ages ranged from 2 months to 16 years, median age 9.7 (6.0-2.3) years. Glasgow scores ranged from 3 to 8, median 6 (4-7). Traffic accidents were responsible for 79.5% of events. Monitoring devices were installed, on average, 14 hours after trauma, median time 24 hours. One hundred and three patients (78%) had IH, while 57 (43.2%) had refractory IH. In multivariate analysis, younger age ranges were associated with IH [relative risk = 1.67 (1.03-2.72); p = 0.037], and abnormal postures were associated with refractory IH [relative risk = 2.25 (1.06-4.78)]. The group mortality rate was 51.5%; it was correlated with use of barbiturates in refractory IH and low cerebral perfusion pressure at the intensive care unit.Conclusions: IH and refractory IH were frequent events in pediatric patients who suffered severe head injuries. The younger the patient, the greater the chance of developing IH. The presence of abnormal postures was found to be a risk factor for refractory IH. No conflicts of interest declared concerning the publication of this article.Suggested citation: Guerra SD, Carvalho LF, Affonseca CA, Ferreira AR, Freire HB. Factors associated with intracranial hypertension in children and teenagers who suffered severe head injuries. J Pediatr (Rio J). 2010;86(1):73-79.

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Effect of barbiturate coma on adrenal response in patients with traumatic brain injury

Llompart‐Pou

Pérez-Bárcena

Raurich

et al. 2007

J Endocrinol Invest

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Indicación del coma barbitúrico en el traumatismo craneoencefálico grave

Cited by 5 publications

References 38 publications

Factors associated with intracranial hypertension in children and teenagers who suffered severe head injuries

Factors associated with intracranial hypertension in children and teenagers who suffered severe head injuries

Fatores associados à hipertensão intracraniana em crianças e adolescentes vítimas de traumatismo crânio-encefálico grave

Effect of barbiturate coma on adrenal response in patients with traumatic brain injury

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