-Secondary cerebral stress of systemic origin in children with severe craniocerebral injuries-.
OBJECTIVE
To assess incidence of secondary brain insults of systemic origin (SBISOs) such as arterial hypotension, hypoxaemia, hypercarbia, and anaemia in severely head injured children; to assess their impact on mortality and morbidity in the short- and long-term.


METHODS
Prospective, open study covering a 24-month period.


METHODS
Seventy-one children, under 15 years of age, admitted to a trauma centre for severe brain injury.


METHODS
Analysis of SBISOs and outcome.


RESULTS
Twenty-five children were admitted with SBISOs. The mortality rate was 37%. After hospitalization, 84% of the children with SBISOs vs 46% without SBISOs had severe disability (Glasgow outcome score = 1, 2 and 3). After 1 year, 20 out of the 45 children still alive were contacted. One of the four with SBISOs communicated a bad recovery. Fifteen children without SBISOs presented good recovery: GOS = 4-5, paediatric overall performance category (POPC scale) = 1-2.


CONCLUSIONS
Hypotension was associated with significant increase in mortality (x 3.6) in children with severe head injury. The consequences were worse when anaemia was associated.
Marescal
C
C
Service d'accueil des urgences, hôpital R-Salengro, CHRU de Lille, France.
Adnet
P
P
Bello
N
N
Halle
I
I
Forget
A P
AP
Boittiaux
P
P
D000293:Adolescent; D000740:Anemia / Q000150:complications / Q000503:physiopathology; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D006935:Hypercapnia / Q000150:complications / Q000503:physiopathology; D007022:Hypotension / Q000150:complications / Q000503:physiopathology; D000860:Hypoxia / Q000150:complications / Q000503:physiopathology; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome