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The outcome of prolonged coma in childhood

L H Margolis, B A Shaywitz

    Pediatrics
    |March 1, 1980
    PubMed

    Insights

    Prolonged nontraumatic coma in children can lead to significant long-term issues. Anoxia, assisted ventilation, elevated intracranial pressure, and deep coma duration are key indicators of poor outcomes.

    Area of Science:

    • Pediatric Neurology
    • Neurocritical Care

    Background:

    • Prolonged nontraumatic coma in children presents complex challenges for clinical decision-making and parental counseling.
    • Understanding prognostic indicators is crucial for managing these critical cases.

    Purpose of the Study:

    • To identify clinical parameters predicting outcomes in children with prolonged nontraumatic coma.
    • To aid in clinical decision-making and parental guidance.

    Main Methods:

    • Retrospective review of 16 children with prolonged nontraumatic coma ( > 5 days).
    • Clinical and neurological examinations, and school reports assessed 1-5 years post-coma.
    • Etiology of coma, need for ventilation, intracranial pressure, and coma depth were analyzed.

    Main Results:

    • Outcomes varied: 6 children normal, 6 with minor handicaps, 4 with major sequelae.
    • Anoxia and need for assisted ventilation correlated with poorer outcomes.
    • Elevated intracranial pressure (> 2 days) and deep coma (> 2 weeks) indicated abnormal outcomes.

    Conclusions:

    • Specific clinical parameters like anoxia, elevated intracranial pressure, and coma duration predict long-term outcomes in pediatric non-traumatic coma.
    • Standardized assessment criteria are needed for better management and evaluation of these children.
    • Further research is warranted given improving care capabilities but limited experience.

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