MassGeneral Hospital for Children, Boston, MA 02114, USA.
Neurotherapeutics. 2012 Jan;9(1):3-16. doi: 10.1007/s13311-011-0093-6.
Pediatric neurocritical care is an emerging multidisciplinary field of medicine and a new frontier in pediatric critical care and pediatric neurology. Central to pediatric neurocritical care is the goal of improving outcomes in critically ill pediatric patients with neurological illness or injury and limiting secondary brain injury through optimal critical care delivery and the support of brain function. There is a pressing need for evidence based guidelines in pediatric neurocritical care, notably in pediatric traumatic brain injury and pediatric stroke. These diseases have distinct clinical and pathophysiological features that distinguish them from their adult counterparts and prevent the direct translation of the adult experience to pediatric patients. Increased attention is also being paid to the broader application of neuromonitoring and neuroprotective strategies in the pediatric intensive care unit, in both primary neurological and primary non-neurological disease states. Although much can be learned from the adult experience, there are important differences in the critically ill pediatric population and in the circumstances that surround the emergence of neurocritical care in pediatrics.
儿科神经危重症医学是一门新兴的多学科医学领域,也是儿科危重症医学和儿科神经病学的新前沿。儿科神经危重症医学的核心目标是通过优化重症监护治疗和脑功能支持,改善患有神经疾病或损伤的危重症儿科患者的结局,并限制继发性脑损伤。儿科神经危重症医学急需循证指南,尤其是在儿科创伤性脑损伤和儿科卒中方面。这些疾病具有独特的临床和病理生理学特征,使其与成人疾病区分开来,并阻止将成人经验直接应用于儿科患者。人们越来越关注在儿科重症监护病房中更广泛地应用神经监测和神经保护策略,包括原发性神经疾病和原发性非神经疾病状态。虽然可以从成人经验中学到很多,但危重症儿科患者群体以及神经危重症医学在儿科中的出现情况存在重要差异。