UvA-DARE is a service provided by the library of the University of Amsterdam (http://dare.uva.nl) UvA-DARE (Digital Academic Repository) Seizures and intracranial dynamics in Kenyan children with acute non-traumatic encephalopathies Gwer, S.A. Link to publication Citation for published version (APA): Gwer, S. A. (2012). Seizures and intracranial dynamics in Kenyan children with acute non-traumatic encephalopathies. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Download date: 07 Feb 2020
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UvA-DARE is a service provided by the library of the University of Amsterdam (http://dare.uva.nl)
UvA-DARE (Digital Academic Repository)
Seizures and intracranial dynamics in Kenyan children with acute non-traumaticencephalopathies
Gwer, S.A.
Link to publication
Citation for published version (APA):Gwer, S. A. (2012). Seizures and intracranial dynamics in Kenyan children with acute non-traumaticencephalopathies.
General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s),other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons).
Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, statingyour reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Askthe Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam,The Netherlands. You will be contacted as soon as possible.
PICU, Cukurova university school of medicine, India Participants: Children with non-traumatic encephalopathies N=67
(n = 25) III - Mannitol 0.5g/Kg and HS (n = 20)
Resolution of coma (mean) I = 123 hrs II = 88.6 hrs III = 87.5 hrs (P = 0.004)
and Mannitol) showed better results in relation to duration of coma and mortality. The authors acknowledge the lack of ICP measurement as a disadvantage in their study and conclude that proper timing of treatment requires ICP monitoring.
done. The combined group was categorized into 2; those who received both agents (A) and those who received hypertonic saline after stopping mannitol (B). The outcomes were not similarly grouped. For the purpose of our review, we have excluded this group. It is not clear whether treatment allocation was done randomly or was period specific. The study includes young infants, a group that needs to be analysed separately because they have immature nervous system and patent fontanelle. This also has a bearing on scoring for coma which is one of the outcomes examined.
Peterson 2000[33]
Design : Retrospective Study Setting: USA Participants: Children with traumatic brain injury and ICP>20mmHg N=68
3% HS infusion
Change in ICP No quantitative data is provided on this
Continuous infusion of HS was efficacious and safe for use in managing raised ICP in paediatric TBI.
ICP monitoring was done but quantitative data to show a dose response effect is not provided. Outcome is well examined for but the lack of a comparison group makes it difficult to conclude on effect of HS use on clinical outcome.
Berger 2002[34]
Case report Setting: Paediatric ICU, Johannes Gutenberg university, Germany Participants: 11 and 12 year old children with traumatic brain injury
20% HS and 20% Mannitol
Change in ICP Bolus administration of either agents resulted in reduction in ICP. This reduction was not sustained in a number of occasions.
HS appeared to reduce post-traumatic increased ICP and improve CPP more effectively than comparable amounts of mannitol.
A dose response effect on ICP with use of both osmotic agents is demonstrated but mannitol appears to cause a reduction in CPP.
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Randomised(n=88)
Severe malaria* + Acidosis (Base deficit>8)(*Impaired consciouness / respiratory distress)
Assessed for eligibility (n=94 )
Albumin (HAS) (n=44)
Protocol deviation (n=0) Less volume than protocol (n=0)Protocol violationnoneSevere adverse eventsAllergy (n=0)Pulmonary oedema (n=0)Suspected raised ICP (n=0)
