Outcome Predictors of Non Traumatic Coma in Children
調査の概要
詳細な説明
Non Traumatic Coma in children is an important pediatric emergency. It has been an enigma for clinicians for many years. To find the cause of coma and to determine the prognosis is a taxing question for the attending clinicians and the primary concern for relatives in every case.
Non-traumatic coma in childhood accounts for high morbidity and mortality in pediatric age group. It can result from wide range of primary etiologies. Etiology of coma and clinical status at the time of admission are likely outcome predictors. Infection is the commonest etiology for coma in all age groups .
Coma in children is recognized to be a non-specific sign with a wide potential differential diagnosis. Among various etiological factors identified for non-traumatic coma, considerable regional diversity exists in them with infectious problems suggested to be more common in developing countries. There has been few case series in developing countries with specific reference to infective etiology and there are also differences in infective agents between developing and developed countries. Similarly prediction of outcome of coma is difficult early in the course of the illness, especially in children. There have been many studies suggesting prognostic parameters of coma in adults, but limited reviews are available for children.
Etiologically it can be divided into two broad categories: those without focal neurologic signs (e.g., metabolic encephalopathies); meningitis syndromes, characterized by fever or stiff neck and an excess of cells in the spinal fluid (e.g., bacterial meningitis, subarachnoid hemorrhage); and conditions associated with prominent focal signs (e.g., stroke, cerebral hemorrhage). In most instances coma is part of an obvious medical problem such as drug ingestion, hypoxia, stroke, trauma, or liver or kidney failure. Conditions that cause sudden coma include drug ingestion, cerebral hemorrhage, trauma, cardiac arrest, epilepsy, or basilar artery embolism. Coma that appears subacutely is usually related to a preceding medical or neurologic problem, including the secondary brain swelling of a mass lesion such as tumor or cerebral infarction.
Central nervous infections are the most common cause . Toxic-metabolic, status-epilepticus, hypoxic-ischemic, intracranial bleed etc. are other main causes.
Neurological outcome is often the foremost concern of parents and physicians .Etiology of coma and clinical status at the time of presentation are the most likely predictors of outcome. Simple clinical signs have been found as good predictors of outcome .
Non-traumatic coma is an important source of morbidity and mortality in the pediatric age group. Accurate diagnosis of etiology of childhood coma in resource poor countries is complicated by overlap in clinical presentation, limited diagnostic resources, disease endemicity and co-morbidity . Considerable skill is required to distinguish the group at high risk for further deterioration, potentially leading either to death or severe handicap. This study attempts to identify the common etiological factors of pediatric comatose patients as well as the predictors of poor outcomes in these patients .
Episodes were defined on the basis of a Glasgow Coma Score (GCS) of less than 12 for more than six hours . Many acutely ill children are not fully conscious because pathologic processes may affect the parts of the central nervous system that mediate consciousness; alteration in the state of consciousness is a common feature of many different conditions.
Many of these children make a full neurological recovery. However, depending on the underlying etiology non-traumatic coma may cause considerable mortality and morbidity in pediatric age group .
研究の種類
入学 (予想される)
連絡先と場所
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- disturbed conscious level
- Children's family signed consent of approval to participate in the study
Exclusion Criteria:
- Children aged <2 months or >18 years.
- Coma of traumatic etiology.
- Coma as part of an anticipated terminal illness.
研究計画
研究はどのように設計されていますか?
デザインの詳細
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
The percentage of recovery from coma
時間枠:1 month
|
clinical evaluation of the recovery symptoms and signs
|
1 month
|
協力者と研究者
スポンサー
捜査官
- 主任研究者:Hanan Zaka、World Health Organization
研究記録日
主要日程の研究
研究開始 (予想される)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- Non Traumatic Coma in Children
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
CT brainの臨床試験
-
Beijing Pins Medical Co., LtdBeijing Tiantan Hospitalわからない
-
ElMindA Ltdわからない
-
University Medicine GreifswaldBDH-Klinik Greifswald募集
-
Royal Brompton & Harefield NHS Foundation TrustUniversity of Oxford; National Institute for Health Research, United Kingdom完了