Etiologia e a morbi-letalidade do coma agudo em crianças

Löhr, Alfredo; Liberalesso, Paulo Breno Noronha; Luzzi, Gisele Claudino Reck; Faria, Antonio Carlos de; Bugallo, Maria Julia Camiña; Santos, Mara Lucia Schmit Ferreira

doi:10.1590/s0004-282x2003000400018

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…In addition, 50% of these children died in emergency ward (18). In another study, the causes of coma in 104 children aged 2 months to 13 years were meningoencephalitis, epilepsy, toxic-metabolic and intracranial hypertension, respectively (19). In the present study, toxic causes including poisoning with methadone and opium were the major causes of loss of consciousness.…”

Section: Discussionsupporting

confidence: 46%

Non-traumatic Coma in Children in South-East of Iran

2014

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Background: Non-traumatic coma is a common condition in children that may cause considerable morbidity and mortality. Determining the most common causes of loss of consciousness in any specific region, and any sex and age group will dramatically reduce mortality and morbidity. Objectives: The purpose of this study was to evaluate the most common causes of non-traumatic coma among children in south east of Iran. Patients and Methods: All children (aged 1 month to 15 years) hospitalized for non-traumatic coma were included in this study. All of the patients received clinical measures such as history, physical, and neurological examinations. Glasgow coma scale (GCS) was used to determine the level of consciousness and paraclinical examinations, including CBC with differential, blood biochemistry, urine analysis, and liver function tests were performed on all patients. In case of indication, blood and urine culture, brain CT (Computed Tomography) scan or brain MRI (Magnetic Resonance Imaging), lumbar puncture, metabolic study, EEG (electroencephalogram), and so forth were carried out. Finally, the data were analyzed and the most common causes of loss of consciousness were determined. Results: Among the 123 children under investigation, 76 cases were male (61.8%) and 47 females (38.2%) with the mean age of 3.2 ± 0.64 years. The most common causes of loss of consciousness among children were as follows: toxic causes in 61 patients (49.6%), infectious causes in 30 patients (24.4%), metabolic causes in 11 patients (8.9%), structural brain abnormalities in 4 patients (3.3%) and seizure in 7 children (5.7%). Moreover, 10 patients (8.1%) had other causes of loss of consciousness. Conclusions: Toxic causes with an incidence of 49.6% were the most common cause of loss of consciousness among all age groups.

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Section: Discussionsupporting

confidence: 46%

Non-traumatic Coma in Children in South-East of Iran

2014

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“…The etiologies of nontraumatic comas are mainly attributed to central nervous system infections (82.43%) both in this study and in others [1,2,4,6,11,13,14,17,18,19,52,53,54,55,56,57,58,59]. Elsewhere, the preponderance of infectious etiology in the occurrence of death in children with non-traumatic comas provides evidence of this [6,10,22,52,60]. If not the observation of septic shock which announces the existence of infections [6,22,61].…”

Section: Diagnostic Approachsupporting

confidence: 70%

Untitled

2022

JPNB

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IntroductionNon-traumatic coma is the most common pediatric medical emergency. Their therapeutic and evolutionary profile remains controversial in resource-limited countries. We report our experience with 370 children. ObjectiveTo evaluate the management and evolution of nontraumatic comas in the intensive care unit of the Pediatric Hospital Complex of Bangui (CHUPB). Materials and methods: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021 at the CHUPB. Children aged 1 month to 15 years, admitted to the intensive care unit of CHUPB with a Glasgow score less than or equal to 8 in a trauma-free setting were included. Data were entered and analyzed using SPSS 20.0 statistical software. The statistical test used was Pearson's chi-square. Any p-value <0.05 was considered statistically significant. ResultDuring the study period, 370 children were admitted to the intensive care unit of CHUPB for non-traumatic coma. The sex ratio was 1.35 and the mean age was 35.95±27.21 months. Neuromalaria (29.72%), meningitis-meningoencephalitis-encephalitis (30%), septic states (19.72%) and acidotic coma (5.40%) were the main etiologies. The children had received emergency drug treatment based on anticonvulsants in 59.18% of cases, antipyretics in 91.35% of cases and dopamine 18.1% of cases. Drug treatment was adapted to the etiology in 44.60% of cases and probabilistic in 55.40% (n=205) of cases. Neurological sequelae were noted in 8.93% of cases and death in 36.48%, 57.77% of which occurred within the first 48 hours. ConclusionInfectious diseases are the predominant cause of biologically documented non-traumatic comas and are also the cause of non-documented clinical situations. This reality has induced the use of anti-infectives beyond the rational with an outcome marked by high mortality and sequelae. The transformation of these outcomes requires the reinforcement of the technical platform of the CHUPB.

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Section: Diagnostic Approachsupporting

confidence: 70%

Therapeutic and Evolutionary Aspects of Non-Traumatic Comas in Central African Children

2022

JPNB

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Introduction Non-traumatic coma is the most common pediatric medical emergency. Their therapeutic and evolutionary profile remains controversial in resource-limited countries. We report our experience with 370 children. Objective To evaluate the management and evolution of nontraumatic comas in the intensive care unit of the Pediatric Hospital Complex of Bangui (CHUPB). Materials and methods: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021 at the CHUPB. Children aged 1 month to 15 years, admitted to the intensive care unit of CHUPB with a Glasgow score less than or equal to 8 in a trauma-free setting were included. Data were entered and analyzed using SPSS 20.0 statistical software. The statistical test used was Pearson’s chi-square. Any p-value <0.05 was considered statistically significant. Result During the study period, 370 children were admitted to the intensive care unit of CHUPB for non-traumatic coma. The sex ratio was 1.35 and the mean age was 35.95±27.21 months. Neuromalaria (29.72%), meningitis-meningoencephalitis-encephalitis (30%), septic states (19.72%) and acidotic coma (5.40%) were the main etiologies. The children had received emergency drug treatment based on anticonvulsants in 59.18% of cases, antipyretics in 91.35% of cases and dopamine 18.1% of cases. Drug treatment was adapted to the etiology in 44.60% of cases and probabilistic in 55.40% (n=205) of cases. Neurological sequelae were noted in 8.93% of cases and death in 36.48%, 57.77% of which occurred within the first 48 hours. Conclusion Infectious diseases are the predominant cause of biologically documented non-traumatic comas and are also the cause of non-documented clinical situations. This reality has induced the use of anti-infectives beyond the rational with an outcome marked by high mortality and sequelae. The transformation of these outcomes requires the reinforcement of the technical platform of the CHUPB.

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Etiologia e a morbi-letalidade do coma agudo em crianças

Cited by 6 publications

References 11 publications

Non-traumatic Coma in Children in South-East of Iran

Non-traumatic Coma in Children in South-East of Iran

Untitled

Therapeutic and Evolutionary Aspects of Non-Traumatic Comas in Central African Children

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