严重脑炎:儿童重症监护病房10年的病因,治疗和结果
Giordano Palmas1,2, Trevor Duke2,3
1Department of Paediatrics, Meyer Children's Hospital IRCCS, Florence, Italy giordano.palmas@gmail.com.
Archives of disease in childhood
|July 24, 2023
概括
严重的儿科脑炎,通常是由肠道病毒或简单疹病毒 (HSV) 引起的,可能导致死亡或残疾. 年轻年龄,特定的病毒原因和长时间的通风是危急病患儿童不良结果的关键风险因素.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染性疾病 传染性疾病
- 神经学 神经学
背景情况:
- 儿童严重脑炎是一种严重的疾病,具有显著的发病率和死亡率.
- 了解各种病因和风险因素对于有效管理至关重要.
研究的目的:
- 描述儿童重症脑炎的流行病学,临床表现,管理策略和严重脑炎的结果,这些情况发生在儿童重症监护病房 (PICU) 的儿童中.
- 在这个儿科群体中确定与严重残疾或死亡相关的危险因素.
主要方法:
- 一项10年回顾性队列研究,涉嫌患有脑炎的儿童 (0-17岁) 进入第三级PICU.
- 收集的数据包括人口统计,临床特征,致病因子,治疗方法 (机械通风,ECMO) 和后续结果 (残疾,死亡).
主要成果:
- 175名儿童因脑炎住院;肠道病毒是最常见的原因 (28%).
- 死亡率为6.3% (11例死亡),人类疹病毒-6 (HHV-6) 是最常见的死亡原因.
- 与严重残疾或死亡相关的因素包括年龄<2岁,疹病毒感染和长时间的输管治疗.
结论:
- 重症儿童脑炎的病因有多种,死亡或严重残疾的风险很大.
- 早期识别高风险因素,如年轻年龄和特定的病毒感染,对于改善结果至关重要.
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