Ventilation non invasive en réanimation pédiatrique : quelles indications en 2010 ?

Noizet-Yverneau, O.; Leclerc, F.; Bednarek, Nathalie; Santerne, B.; Akhavi, A.; Pomédio, M.; David, Antonio; Morville, P

doi:10.1016/j.annfar.2009.11.015

Cited by 13 publications

(3 citation statements)

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“…Mapoure in Dakar [35] reported the systematic use of nasal oxygen therapy in adult comatose patients and -comparing the outcome of the patients who benefited from the non-invasive method with that of Zambian patients on mechanical ventilation -underlined the contribution of the invasive method to the survival of Zambian patients. This suggestion should not, however, elude the fact that in non-traumatic comas the decision to intubate is based on the patient's ability to protect his upper airway, the estimated time to recovery and the depth of the coma (Glasgow < 8) [36,37]; considering above all oxygen as a drug [38]. As such, its prescription is subject to specific indications and prescription rules [39].…”

Section: Prise En Charge Ventilatoirementioning

confidence: 99%

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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: Prise En Charge Ventilatoirementioning

confidence: 99%

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2022

JPNB

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Section: Prise En Charge Ventilatoirementioning

confidence: 99%

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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“…Les troubles de la conscience représentent une contreindication formelle à la ventilation non invasive (VNI), à l'exception de l'insuffisance respiratoire hypercapnique [26]. La VNI dans cette situation nécessite une surveillance rapprochée par un personnel qualifié et expérimenté [27] : le pédiatre-réanimateur doit avoir au préalable précisément défini le délai de réponse au traitement afin de ne pas prolonger une situation à risques.…”

Section: Principales Causes De Coma Du Nourrisson Et De L'enfant Et Lunclassified