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  • Công bố khoa học và công nghệ Việt Nam

76.29.30

Y học lâm sàng

Đậu Việt Hùng, Trần Minh Điển(1), Phạm Văn Thắng

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

Evaluation of cerebral perfusion pressure prediction for encephalitis treatment

Y học Việt Nam

2014

1

102-105

1859-1868

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.

TTKHCNQG, CVv 46