儿科创伤性脑损伤的初始失血症和临床结果:一个多中心观察性研究
Gawin Mai1, Jan Hau Lee2,3, Paula Caporal4,5
1Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
Acta neurochirurgica
|February 14, 2024
概括
初始失血,包括低血和高血,显著增加了创伤性脑损伤 (TBI) 的儿童的住院死亡率和不良功能结果. 超血症与不良结果有着特别强烈的联系.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 神经科学是一个神经科学.
- 内分泌学 在内分泌学.
背景情况:
- 儿童的创伤性脑损伤 (TBI) 是导致死亡和长期残疾的主要原因.
- 电解质不平衡,特别是缺血血 (血清水平异常),在危急病患者中很常见.
- 初始失血症对儿科TBI结局的影响仍然不完全理解.
研究的目的:
- 调查TBI儿童初始失血症 (低血和高血) 与住院死亡率之间的关联.
- 检查儿科TBI后初始失血症和功能性结果之间的关系.
- 为了比较患有低血症,高血症和欧血症的儿童之间的结果.
主要方法:
- 一项多中心观察性研究,涉及26个儿科重症监护病房.
- 在受伤24小时内出现TBI的18岁以下儿童的招募.
- 用多变量逻辑回归分析人口统计,临床特征,住院死亡率和功能结果 (通过儿科大脑性能类别分数定义).
主要成果:
- 在648名儿童中,13.0%患有低血,6.5%患有高血.
- 初始的低血和高血与较少的无通风和无ICU日相比,与eu-natremia相关.
- 调整后的分析显示,呈现低血与增加住院死亡率 (aOR=2.47) 和功能性结果差 (aOR=1.67) 有关.
- 最初的超血症与死亡率 (aOR=5.91) 和不良结局 (aOR=3.00) 有更强的关联.
结论:
- 儿科TBI患者的初始失水症与较高的住院死亡率和较差的功能结果显著相关.
- 超血症与死亡率和功能结果都有特别强烈的不良关联.
- 建议进行进一步的研究,以探索儿科TBI的纵向水平监测及其与临床结果的相关性.
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