Elwagei Ahmed Suliman
Pediatrics Department, The National Ribat University, Khartoum, SDN.
Cureus. 2022 Sep 23;14(9):e29510. doi: 10.7759/cureus.29510. eCollection 2022 Sep.
Inspirational enlightenment has guided me to write this review article while encountering, during my practice as a pediatrician, referred cases of previously stable, positively progressing cerebral palsy (CP) children who had not yet celebrated their first teen birthday but ended up being in a deep coma and mechanical ventilation-dependent post a cardiac arrest outside the hospital. The dramatic end was believed to be probably caused by food aspiration, which could have been prevented by effective counseling to the in-denial, struggling parents about their children's condition. This report tries to emphasize the importance of effective communication between physicians and caregivers of children who were diagnosed with CP. The importance is elaborated by linking the level of the provided communication/education to the caregivers with cerebral injuries, such as intracranial hemorrhage (ICH), which potentially could have been prevented among CP children. The sequence of the injury is believed to be initiated by aspiration of food, which resulted in apnea/asphyxia, followed by a cardiopulmonary arrest outside hospital settings. Such a life-threatening event is hypothesized to be the leading cause of non-reversible intracranial injuries to the CP child of misinformed/unaware parents. Data on unsolved parental status, parent-provider miscommunications, and aspiration pneumonia leading to cerebral injuries and their permanent neurological insult in CP children were reviewed.
在我作为一名儿科医生的执业过程中,遇到了一些转诊过来的病例,这些患有脑瘫(CP)的儿童原本病情稳定且进展良好,还未到青少年时期,但最终在院外心脏骤停后陷入深度昏迷并依赖机械通气。这段经历启发我撰写了这篇综述文章。这种戏剧性的结局被认为可能是由食物误吸导致的,而通过对那些否认事实、苦苦挣扎的家长就其孩子的病情进行有效咨询,这本可避免。本报告试图强调在被诊断为脑瘫的儿童的医生与照料者之间进行有效沟通的重要性。通过将所提供给患有脑损伤(如颅内出血,ICH)的照料者的沟通/教育水平与脑瘫儿童中潜在可预防的情况相联系,来阐述这种重要性。据信,损伤的序列是由食物误吸引发的,这导致了呼吸暂停/窒息,随后在院外环境中发生心肺骤停。这样一个危及生命的事件被认为是导致信息错误/不知情的家长的脑瘫儿童发生不可逆颅内损伤的主要原因。本文回顾了关于脑瘫儿童中未解决的家长状况、家长与医疗提供者之间的沟通失误以及导致脑损伤及其永久性神经损伤的吸入性肺炎的数据。