Coma du nourrisson et de l’enfant : prise en charge initiale

Sachs, P.; Michot, C.; Naudin, J.; Madre, C.; Aizenfisz, Sophie; Dauger, Stéphane

doi:10.1007/s13546-011-0291-6

Cited by 5 publications

(11 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The management of a comatose child is based on two essential and complementary aspects: on the one hand, to ensure the immediate management of vital complications; and on the other hand, to set up a therapy targeting the cause thanks to the determination of the level and the mechanism of damage to the central nervous system, by means of a meticulous clinical examination and certain biological and neuroradiological tests [25]. These essential aspects, evoked by Sachs [12], led us to discuss the therapeutic attitudes and the evolution of patients both in the emergency department and in the intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

“…The contents of the emergency cart are thus organized according to the needs of each ABC (Airway, Breathing, and Circulation) procedure. These means of screening and procedures reflect the need to have pre-established strategies for the organization of human and material resources in these services [12]. However, the Bangui emergency medical service, the only place of reference, receives emergencies from the whole country and from the neighboring regions of the Democratic Republic of Congo.…”

Section: Discussionmentioning

confidence: 99%

“…During the day, medical interventions are provided by two out of four resident physicians under the supervision of a senior pediatrician. The intensive care team is not coordinated by a resuscitator, although it should normally be in order to systematize and prioritize the management in order to orient the therapeutic approach and avoid iatrogeny [12].…”

Section: Therapeutic Attitude In Intensive Carementioning

confidence: 99%

“…These include malaria and neuromeningeal infections, especially infectious meningitis [2][3][4][5][6][7][8][9][10]. The incidence of non-traumatic comas in chil-dren worldwide is 30 per 100,000 children [11][12]. This incidence varies according to the continent.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Untitled

2022

JPNB

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Therapeutic Attitude In Intensive Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Untitled

2022

JPNB

View full text Add to dashboard Cite

show abstract

“…Adolescents tend to experience alcohol, psychoactive substances, or recreational drugs. In the absence of an obvious history, toxicological exams need to be conducted in serum and urine [29,30].…”

Section: Anamnestic and Clinical Diagnosis Of Toxic Comasmentioning

confidence: 99%

Poisoning in the Pediatric Intensive Care Unit

Nistor¹,

Frăsinariu²,

Rugină³

et al. 2019

Poisoning in the Modern World - New Tricks for an Old Dog?

View full text Add to dashboard Cite

Poisonings during childhood (both accidental and voluntary) are a common cause of presentation in the emergency departments (EDs) and the pediatric intensive care unit (PICU). The admission to PICU is warranted both for treatment and for continuous monitoring, as sometimes the evolution of a poisoning could be unpredictable. Sometimes, complications arise that may prolong the patients' hospitalization and may contribute to lowering the survival rate. The staff in these departments must be well trained to ensure patient monitoring, early detection of complications, and rapid intervention. Supporting vital functions is the main objective of the management of a poisoned patient admitted in PICU. In recent years, staff competence and advanced medical technology have helped to improve the prognosis of the patients admitted to these departments, including of the poisoned patients.

show abstract