Prise en charge du traumatisme crânien cérébral grave

Ben-Hamouda, Nawfel; Oddo, Mauro

doi:10.1007/s13546-012-0620-4

Cited by 1 publication

(1 citation statement)

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“…This choice underlines the importance of our nding that only 22% of our population had no mSSI early after their resuscitation from potential cerebral injuries. Prevention of secondary brain damage of systemic origin is well known to improve outcomes after both traumatic brain injury and stroke [6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Metabolic secondary systemic insults among newborns with encephalopathy and their outcome: a descriptive single-center cohort study

Garnaud,

Soreze,

Blondiaux

et al. 2023

Preprint

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Purpose: To evaluate the frequency of metabolic secondary systemic insults (mSSI) and its association with mortality in newborns with encephalopathy. Methods This single-center observational study of neonatal encephalopathy (NE) in patients in 2018–2020 defined mSSI as at least one abnormal finding for any of glucose, sodium, and/or carbon dioxide from routine blood samples during the first 3 days of life. Thresholds were hypoglycemia, <2 mmol/L; hyperglycemia, >10 mmol/L; hyponatremia, <130 mmol/L; hypernatremia, >150 mmol/L; hypocapnia, <30 mmHg; and hypercapnia, >70 mmHg. The cumulative number of mSSIs was the sum of these six types. The primary outcome was in-hospital mortality. Results Among the 109 newborns included, 22% presented no mSSI, 35% one type, 28% two, 11% three, and 4% four. The cumulative number of mSSIs was significantly (p<0.01) associated with the 5-minute Apgar score and the severity of hypoxic-ischemic encephalopathy; 8.3% of infants with no mSSI, 24.3% with one, 42.3% with two, and 53.8% with three or more mSSIs were graded Sarnat III (p<0.01). Mortality was significantly (p = 0.009) associated with the cumulative number of mSSI types: 0/24 patients with no mSSI, 2/38 (5.3%) patients with one type, 3/31 (9.7%) with two types, and 5/16 (31.3%) with three or more types. Conclusion: Among the neonates hospitalized for NE, mSSI concerned 80%. The cumulative number of mSSI types was significantly associated with mortality. Further studies are needed to evaluate the prognostic impact of controlling these mSSIs.

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Section: Discussionmentioning

confidence: 99%