Udani Soonu
Department of Pediatrics and Pediatric Intensive Care, P D Hinduja Hospital, Veer Savarkar Marg, Mahim, Mumbai, 400016, India,
Indian J Pediatr. 2015 Mar;82(3):272-6. doi: 10.1007/s12098-014-1586-1. Epub 2014 Oct 14.
The neurologically injured child, whether from trauma or other causes, is a common admission into any Pediatric critical care unit. Whatever the cause, the risk for death and life long disability remains very high. Unlike the adult population, neurological diseases in children are diverse and arise from a variety of factors that vary greatly in age and presentation. Nervous system dysfunction is often a complication of critical illness and interventions. While neurointensive care units may be ideal for the at-risk child, in mixed units, 40 % of admissions may be neurological or have neurological complications. Improved quality of care and the application of protocols and bundles, appear to have contributed significantly to improved outcomes. Since we are constantly facing an uphill task of dealing with deterioration while trying to preserve function, detection of early shifts of any nature would be deemed helpful. The intensivist must focus not only on saving life but also on preventing disability with full awareness that responsibility does not end with discharge from the pediatric intensive care unit (PICU). Outcome audits should include not only deaths and discharge from PICU but also one year mortality and even degree of disability at the end of one year from discharge.
患有神经损伤的儿童，无论病因是创伤还是其他，都是儿科重症监护病房的常见收治对象。无论病因如何，死亡和终身残疾的风险仍然非常高。与成人不同，儿童神经疾病多种多样，由各种在年龄和表现上差异很大的因素引起。神经系统功能障碍往往是危重病和干预措施的并发症。虽然神经重症监护病房可能是高危儿童的理想选择，但在综合病房中，40%的收治病例可能是神经疾病或有神经并发症。护理质量的提高以及方案和集束护理的应用，似乎对改善预后有显著贡献。由于我们在努力保留功能的同时不断面临应对病情恶化的艰巨任务，检测任何性质的早期变化都将被视为有帮助。重症监护医生不仅必须专注于挽救生命，还必须专注于预防残疾，同时要充分意识到责任并不随着从儿科重症监护病房（PICU）出院而结束。预后审计不仅应包括PICU的死亡和出院情况，还应包括一年死亡率，甚至出院后一年的残疾程度。
