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Master Thesis

Prise en charge des nourrissons victimes du syndrome du bébé secoué admis en réanimation pédiatrique au CHU de Caen de 2009 à 2019

Abstract : Objectives: describe the management of infants who are victims of shaking and identify prognostic factors for sequelae or death. Methods: all patients under the age of 3 years admitted in pediatric intensive care unit at Caen University hospital for definite or probable shaken baby syndrom diagnosis are subject to descriptive retrospective and monocentric analysis. Results: forty-seven 5 months-old patients (3,5 – 6,5) were admitted. Thirty-seven (79%) benefit from mechanical ventilation, seven (15%) have hemodynamic support, 21 (45%) received osmotherapy and thirty-one (66%) neurosurgical management. Five (11%) died. At the end of hospitalization, seventeen (36%) have neurological sequelae and nine (19%) visual impairments. These children are more likely to use mechanical ventilation for more than 24 hours (p=0,001), hemodynamic support (p<0,05), osmotherapy and two anti epileptic therapies for a convulsive state (p=0,01). A Glasgow initial score ≤8 (p<0,01), pupillary anomaly (p<0,01), apnea episodes (p<0,01), abnormal cerebral velocity on transcranial doppler (p=0,01), axonal lesions on MRI (p<0,01) as well as electroencephalogram brain pain (p<0,01) are the main risk factors found. Conclusion: clinical and paraclinical examination of shaken infants give prognosis of the immediate future of these patients. The knowledge of these risk factors can guide the management of these most serious patients.
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Master Thesis
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Charlotte Roulland. Prise en charge des nourrissons victimes du syndrome du bébé secoué admis en réanimation pédiatrique au CHU de Caen de 2009 à 2019. Médecine humaine et pathologie. 2019. ⟨dumas-02495815⟩

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