与烧伤和复苏有关的神经系统并发症
Connor L Kenney1, Brian D Stephens2, Kelsey A Cacic3
1Brooke Army Medical Center, San Antonio, Texas; Uniformed Services University of Health Sciences, Bethesda, Maryland.
The Journal of surgical research
|November 8, 2024
概括
在烧伤患者中,高体积液体复苏 (>200毫升/千克) 可能导致神经学发现恶化,可能表明内区综合征. 这强调了在烧伤治疗期间需要仔细监测神经病情的必要性.
科学领域:
- 创伤和重症监护医学 创伤和重症监护医学
- 神经科学是一个神经科学.
- 燃烧管理 燃烧管理
背景情况:
- 液体复苏对于由于系统性炎症造成的大型烧伤至关重要.
- 改善的重症监护已经减少了与烧伤相关的发病率和死亡率.
- 神经系统并发症,如内区综合征,是过度复苏在烧伤患者的未被认可的后果.
研究的目的:
- 研究燃烧患者高体积液体复苏与神经系统并发症之间的关联.
- 评估200毫升/公斤的复苏体积值是否与神经病发现的恶化相关.
主要方法:
- 对受伤后24小时内进入烧伤重症监护室的患者的回顾性审查.
- 患者根据液体复苏体积分为组:≤200mL/kg和>200mL/kg.
- 神经成像在96小时内进行,以评估神经学发现.
主要成果:
- 分析了41名患者;30人接受≤200毫升/公斤,11人接受>200毫升/公斤.
- 在两组中,重复神经影像是常见的 (70.0%对63.6%).
- 随访成像时神经学发现的恶化在高体积复苏组 (>200毫升/千克) (85.7%对47.6%,P=0.064) 中更为普遍.
结论:
- 在烧伤患者中,高体积液体复苏 (>200毫升/千克) 与神经系统病变的发生率更高有关.
- 神经学并发症可能表现为内区综合征,可通过神经影像检测.
- 临床医生应考虑在接受激烈液体复苏的烧伤患者中进行神经学监测.
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