巴比妥类药物治疗重型颅脑损伤儿童顽固性颅内高压的疗效观察。

T Pittman, R Bucholz, D Williams
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引用次数: 45

摘要

脑灌注压(CPP)低于50torr与边际脑血流量和预后不良相关。我们报告了一组7名儿童在戊巴比妥治疗期间长期存活,CPP小于50 torr。该研究小组是通过对1984年至1986年间格伦农主教纪念儿童医院收治的所有头部受伤患者的回顾性审查确定的。所有患者均持续颅内压大于20torr,对常规治疗无效。所有患者接受戊巴比妥治疗至少24小时,并且在此期间所有记录的CPP均小于50 torr,持续时间超过30分钟。7例患儿中:3例恢复良好;2人中度残疾,2人植物人。CPP和戊巴比妥昏迷时间都不能准确预测结果。这些儿童似乎是先前定义为顽固性颅内高压的儿童的一部分,作为一个群体,他们可能从戊巴比妥治疗中受益。同样明显的是,在这一组中,低CPP并不意味着不可逆的脑损伤或脑死亡。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of barbiturates in the treatment of resistant intracranial hypertension in severely head-injured children.

Cerebral perfusion pressures (CPP) of less than 50 torr are associated with marginal cerebral blood flow and poor outcome. We report our experience with a group of 7 children who survived long period with CPP of less than 50 torr during treatment with pentobarbital. The study group was identified through a retrospective review of all head-injured patients admitted to Cardinal Glennon Memorial Hospital for Children between 1984 and 1986. All of the patients presented had sustained intracranial pressure of greater than 20 torr which was resistant to conventional therapy. All patients received pentobarbital for at least 24 h and all had documented CPP of less than 50 torr for more than 30 min during that time. Of these 7 children: 3 made good recoveries; 2 are moderately disabled, and 2 are vegetative. Neither the CPP nor the length of pentobarbital coma was an accurate predictor of outcome. It seems likely that these children are a subset of those previously defined as having resistant intracranial hypertension and that, as a group, they may have benefited from pentobarbital administration. It is also apparent that, in this group, low CPP was not indicative of irreversible brain damage or brain death.

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