Giá trị của áp lực tưới máu não đối với tiên lượng kết quả điều trị bệnh nhân viêm não

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Tác giả: Việt Hùng Đậu, Văn Thắng Phạm, Minh Điển Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 612.824 Circulation

Thông tin xuất bản: Y học Việt Nam, 2014

Mô tả vật lý: 102-105

Bộ sưu tập: Metadata

ID: 503911

CPP threshold targeted treatment accepted commonly in adult but for children, optimizing cerebral perfusion pressure in intracranial hypertension treatment still continues to generate controversy. Therefore, the identification of CPP's thresholds with the prognostic ability for encephalitis treatment outcome in children is aim of study. Method: An observational study. During 4 years from 2010 to 2013, 35 children, who were diagnosed with encephalitis, Glasgow coma scale under 8 points and head cr scan sign of cerebral edema, were indicated for continous intracranial pressure monitoring and direct measurement of intracranial pressure in the parenchyma monitoring by SPM-1 and MPM-1 monitor of Integra neurosciences. Management of intracranial hypertension were applied when ICP increase more than 20 mmHg. Invasive arterial pressure was placed and monitored continuously by Nihon Kohden monitor. CPP was calculated by formula: CPP = MAP - ICP (MAP, mean arterial pressure). Result: Study show the avergage age of patient is 49.56 months, 18 survivor, 17 death. 80 percent of patients did not identify an underlying cause of encephalitis. There are different between minimal CPP and mean CPP with survivor and death group (59.98 + or - 15.96 vs 42.71 + or - 15.64 mmHg and 43.47 + or - 9.42 vs 20.35 + or - 20.35 mmHg). CPP below 40 mmHg is associated with death. CPP threshold value greater than 50.5 mmHg is found to be the critical threshold in intracranial hypertension management for children. Conclusion: CPP had good prediction for outcome of encephalitis treatment in children.
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