Aslan Nagehan, Yıldızdaş Dinçer
Department of Pediatric Intensive Care, Malatya Training and Research Hospital, Malatya, Turkey.
Department of Pediatric Intensive Care, Çukurova University Faculty of Medicine, Adana, Turkey.
Turk Arch Pediatr. 2022 Jul;57(4):421-427. doi: 10.5152/TurkArchPediatr.2022.21247.
In patients with severe traumatic brain injury, it is possible to obtain a good long- term prognosis, prevent secondary injury, and decrease morbidity and mortality with the administration of appropriate treatments in the acute period. This study aims to evaluate the approaches of the pediatric intensive care specialists in Turkey towards the follow-up and treatment of severe traumatic brain injury by using a survey that had been prepared in light of the current pediatric severe traumatic brain injury guideline.
The survey, which included 45 questions, was prepared on the SurveyMonkey® system sent by e-mail to the centers, which were members of the Turkish Society of Pediatric Emergency and Intensive Care Medicine.
A total of 45 centers participated in the survey. In all centers, computed tomography of the brain was found to be the first choice as an imaging method for traumatic brain inju- ries. In terms of hyperosmolar therapy, 30 (66.6%) centers stated that they used 3% hypertonic saline, and 16 (35.5%) centers stated using 3% hypertonic saline+mannitol. Forty (86.96%) cen- ters stated that they did not use prophylactic hyperventilation in the first 48 hours. A total of 44 centers (97.78%) stated that they administered prophylactic antiepileptic drugs in the first 7 days while the most preferred antiepileptic drug was levetiracetam.
The results of our survey supported that the pediatric intensive care specialists in Turkey planned a large percentage of the treatment for patients with severe traumatic brain injury in line with the published traumatic brain injury guidelines.
对于重度创伤性脑损伤患者,在急性期给予适当治疗有可能获得良好的长期预后、预防继发性损伤并降低发病率和死亡率。本研究旨在通过一项根据当前儿科重度创伤性脑损伤指南编制的调查问卷,评估土耳其儿科重症监护专家对重度创伤性脑损伤的随访和治疗方法。
该调查问卷包含45个问题,通过电子邮件发送至土耳其儿科急诊与重症医学学会成员中心的SurveyMonkey®系统上编制而成。
共有45个中心参与了此次调查。在所有中心,脑部计算机断层扫描被发现是创伤性脑损伤成像方法的首选。在高渗治疗方面,30个(66.6%)中心表示他们使用3%高渗盐水,16个(35.5%)中心表示使用3%高渗盐水+甘露醇。40个(86.96%)中心表示他们在最初48小时内不使用预防性过度通气。共有44个中心(97.78%)表示他们在最初7天内给予预防性抗癫痫药物,而最常用的抗癫痫药物是左乙拉西坦。
我们的调查结果支持,土耳其的儿科重症监护专家根据已发布的创伤性脑损伤指南,为重度创伤性脑损伤患者规划了很大比例的治疗方案。