Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.
Pediatr Neurol. 2022 Apr;129:62-71. doi: 10.1016/j.pediatrneurol.2022.01.006. Epub 2022 Feb 2.
Children with acute neurologic illness are at high risk of mortality and long-term neurologic disability. Severe traumatic brain injury, cardiac arrest, stroke, and central nervous system infection are often complicated by cerebral hypoxia, hypoperfusion, and edema, leading to secondary neurologic injury and worse outcome. Owing to the paucity of targeted neuroprotective therapies for these conditions, management emphasizes close physiologic monitoring and supportive care. In this review, we will discuss advanced neurologic monitoring strategies in pediatric acute neurologic illness, emphasizing the physiologic concepts underlying each tool. We will also highlight recent innovations including novel monitoring modalities, and the application of neurologic monitoring in critically ill patients at risk of developing neurologic sequelae.
患有急性神经系统疾病的儿童死亡率和长期神经系统残疾的风险很高。严重创伤性脑损伤、心脏骤停、中风和中枢神经系统感染常伴有脑缺氧、灌注不足和水肿,导致继发性神经损伤和更差的结果。由于针对这些疾病的靶向神经保护治疗方法有限,因此管理强调密切的生理监测和支持性护理。在这篇综述中,我们将讨论儿科急性神经系统疾病中的高级神经监测策略,强调每种工具背后的生理概念。我们还将重点介绍最近的创新,包括新型监测模式,以及在有发生神经系统后遗症风险的危重症患者中应用神经监测。