Siddiqui Emad Uddin, Waheed Shahan, Perveen Feroza, Daniyal Muhammad, Raffay Khan Muhammad Abdul, Siddiqui Saif, Siddiqui Zain
Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2019 Nov;69(11):1741-1745. doi: 10.5455/JPMA.296439..
To determine the clinical outcome and mean length of hospital stay of paediatric patients with severe blunt traumatic head injury (THI) receiving 3% hypertonic saline (HTS) in the Emergency Department (ED).
This case series study was conducted at the Department of Emergency Medicine, Aga Khan University Hospital, Karachi, from 2014 to 2015 via chart review of 105 patients. Detailed history and clinical examination of all paediatric patients aged 2-16 years was recorded which included moderate to severe head injury as classified by the Glasgow Coma Scale (GCS) by the Brain Trauma Foundation. As per routine care after admission of such a patient, for resuscitation 3% HTS was administered. GCS was recorded at 6 hours and at the time of discharge.
Of the 105 patients, 76 (72.4%) were male and 29 (27.6%) were female, and the mean age was 61.6+45.9 months. Traumatic brain injury (TBI) was found moderate in 60 (57.1%) cases and severe in 45 (42.9%) of our patients as per the GCS. Six hours after resuscitation with 3% hypertonic saline, 45 (43%) patients normalised as per GCS, 39 (37%) patients had moderate TBI and 21 (20%) had severe TBI. Forty five patients had a hospital stay of 2-3 days. The GCS improved after resuscitation with 3% hypertonic saline in emergency department, with a mean length of stay of 4.6+3.9 and 12.6+10.7 days in moderate and severe head injury respectively with a P value of <0.001, and was normal in 94 (89.5%) patients at the time of discharge.
Paediatric patients with TBI receiving 3% hypertonic saline results in improved GCS and a decrease in the length of hospital stay.
确定急诊科中接受3%高渗盐水（HTS）治疗的重度钝性创伤性脑损伤（THI）儿科患者的临床结局及平均住院时间。
本病例系列研究于2014年至2015年在卡拉奇阿迦汗大学医院急诊科开展，通过查阅105例患者的病历进行。记录了所有2至16岁儿科患者的详细病史和临床检查情况，其中包括根据脑创伤基金会的格拉斯哥昏迷量表（GCS）分类的中度至重度颅脑损伤。按照此类患者入院后的常规护理，给予3%高渗盐水进行复苏。在6小时及出院时记录GCS。
105例患者中，76例（72.4%）为男性，29例（27.6%）为女性，平均年龄为61.6±45.9个月。根据GCS，60例（57.1%）患者的创伤性脑损伤（TBI）为中度，45例（42.9%）为重度。用3%高渗盐水复苏6小时后，45例（43%）患者的GCS恢复正常，39例（37%）患者为中度TBI，21例（20%）为重度TBI。45例患者的住院时间为2至3天。在急诊科用3%高渗盐水复苏后GCS有所改善，中度和重度颅脑损伤患者的平均住院时间分别为4.6±3.9天和12.6±10.7天，P值<0.001，94例（89.5%）患者出院时GCS恢复正常。
接受3%高渗盐水治疗的TBI儿科患者GCS得到改善，住院时间缩短。
