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儿童严重创伤性脑损伤、颅内压、脑灌注压:意味着什么?文献复习。

Children With Severe Traumatic Brain Injury, Intracranial Pressure, Cerebral Perfusion Pressure, What Does it Mean? A Review of the Literature.

机构信息

Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.

Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio.

出版信息

Pediatr Neurol. 2019 May;94:3-20. doi: 10.1016/j.pediatrneurol.2018.12.003. Epub 2019 Jan 11.

Abstract

Severe traumatic brain injury is a leading cause of morbidity and mortality in children. In 2003 the Brain Trauma Foundation released guidelines that have since been updated (2010) and have helped standardize and improve care. One area of care that remains controversial is whether the placement of an intracranial pressure monitor is advantageous in the management of traumatic brain injury. Another aspect of care that is widely debated is whether management after traumatic brain injury should be based on intracranial pressure-directed therapy, cerebral perfusion pressure-directed therapy, or a combination of the two. The aim of this article was to provide an overview and review the current evidence regarding these questions.

摘要

严重创伤性脑损伤是儿童发病率和死亡率的主要原因。2003 年,脑外伤基金会发布了指南,此后该指南不断更新(2010 年),有助于规范化和改善治疗。护理的一个有争议的领域仍然是放置颅内压监测器是否有利于创伤性脑损伤的管理。另一个广泛争论的护理方面是,创伤性脑损伤后的管理是否应基于颅内压导向治疗、脑灌注压导向治疗或两者的结合。本文的目的是提供一个概述,并回顾这些问题的当前证据。

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