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Master Thesis

Traumatisme crânien grave en service de réanimation pédiatrique : étude des pratiques de prise en charge au sein des services de réanimation pédiatrique francophones : protocole PTBIS – Pediatric Traumatic Brain Injury Survey

Abstract : Best strategies for the management of severe paediatric traumatic brain injury (TBI) are not clearly established with wide variations among professional practices. This study's main objective was to assess the adequacy between professional practices and paediatric TBI guidelines 2019. A survey was conducted among French-speaking pediatric intensive care clinicians from April 1st to June 30th, 2019. The survey was conducted as a progressive clinical case with 70 questions based on guidelines 2012. The questions related to the assessment and management of TBI during the acute and intensive care phase. Seventy-eight surveys were included. The adherence to guidelines 2019 was good, with 11 items out of 15 obtaining an adherence rate of more than 60%. There was strong agreement among clinicians on the intracranial pressure (> 80%) and cerebral perfusion pressure (> 70%) thresholds used according to age. Strong adherence to recent guidelines was achieved: seizure prophylaxis with levitracetam (n=21/33, 64%) and capnia threshold (n=52, 67%). On the other hand, the natremia and glycemia thresholds and the role of transcranial doppler were not consistent. Assessment of brain tissue oxygenation (n=12, 16%) and autoregulation (n=35; 45%) was not a common practice. Overall, practices for the management of TBI appear to be standardised. Variations persist in areas where there is a lack of literature and guidelines in paediatrics, so clinicians seem to refer to adult guidelines.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02491422
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Submitted on : Wednesday, February 26, 2020 - 10:24:27 AM
Last modification on : Friday, April 10, 2020 - 1:41:08 AM
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  • HAL Id : dumas-02491422, version 1

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Manon Denis. Traumatisme crânien grave en service de réanimation pédiatrique : étude des pratiques de prise en charge au sein des services de réanimation pédiatrique francophones : protocole PTBIS – Pediatric Traumatic Brain Injury Survey. Médecine humaine et pathologie. 2019. ⟨dumas-02491422⟩

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