Severe head injury in early infancy: analysis of causes and possible predictive factors for outcome.
ABSTRACT The aim of this study was to analyse the causes and prognostic factors for outcome in severe traumatic brain injuries (TBI) in early infancy.
We present a retrospective study on 16 infants aged less than 12 months observed over the last 20 years in our department for severe brain injury. Infants were evaluated by the Children Coma Scale (CCS). We assessed Glasgow Outcome Scale (GOS) at discharge and at 12 months after discharge.
The main causes of trauma were domestic accidents followed by car accidents. The highest positive correlation was found between the GOS score at 1 year and the presence of hypoxia and hypotension at admission, the presence of hyperglycaemia at 24 h and the occurrence of major clotting disorders. A significant but weaker correlation was found with the CCS at admission, the occurrence of early post-traumatic seizures and the length of stay in the intensive care unit.
Full-textDOI: · Available from: Elisabetta Marton, Jun 02, 2015
SourceAvailable from: eugeniomedea.it
[Show abstract] [Hide abstract]
ABSTRACT: Trauma remains the leading cause of morbidity and mortality in the United States among children from the age 1 year to 21 years old. The most common cause of lethality in pediatric trauma is traumatic brain injury (TBI). Early coagulopathy has been commonly observed after severe trauma and is usually associated with severe hemorrhage and/or traumatic brain injury. In contrast to adult patients, massive bleeding is less common after pediatric trauma. The classical drivers of trauma-induced coagulopathy (TIC) include hypothermia, acidosis, hemodilution and consumption of coagulation factors secondary to local activation of the coagulation system following severe traumatic injury. Furthermore, there is also recent evidence for a distinct mechanism of TIC that involves the activation of the anticoagulant protein C pathway. Whether this new mechanism of posttraumatic coagulopathy plays a role in children is still unknown. The goal of this review is to summarize the current knowledge on the incidence and potential mechanisms of coagulopathy after pediatric trauma and the role of rapid diagnostic tests for early identification of coagulopathy. Finally, we discuss different options for treating coagulopathy after severe pediatric trauma.Shock (Augusta, Ga.) 02/2014; 41(6). DOI:10.1097/SHK.0000000000000151 · 2.73 Impact Factor