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Master Thesis

Description et impact du doppler transcrânien en réanimation chez 152 enfants sans traumatisme crânien

Abstract : Background: transcranial doppler (TCD) detects cerebral blood flow modifications at the bedside of critically ill children. Use and impact of TCD is unknown. Material and methods: this prospective and multicentric study characterized patients who had TCD, and related impact according to the intensivist. A questionnaire was completed for each performed TCD. Factors associated with diagnostic and therapeutic impacts were identified. Results: 152 patients were included. TCD was performed in 6.7% of admitted patients. 70% of included patients had a neurological diagnosis. TCD was performed for monitoring of neurological disorder in 56% of cases. Among the TCD suspected abnormalities, intracranial hypertension was more often searched by young operators, and hyperperfusion by experienced intensivists. Discrepancy between the interpretation of TCD values and published reference values was found in 116 patients (76%). TCD had an impact for 131 patients (86%), with a strong impact for 98 patients (64%). Hemodynamic dysfunction (OR 6.4 ; p=0,007) and less experienced operators (OR 3.9; p=0,012) were independent factors affecting therapeutic impact. Conclusion: TCD had an important impact, dependent on the operator’s experience and on the patient’s severity. Its interpretation is complex. Improvement of the use of TCD is necessary.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01656387
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Submitted on : Tuesday, December 5, 2017 - 3:53:11 PM
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Virginie Rollet-Cohen. Description et impact du doppler transcrânien en réanimation chez 152 enfants sans traumatisme crânien . Médecine humaine et pathologie. 2016. ⟨dumas-01656387⟩

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