Journal article
Abnormal intra-aural pressure waves associated with death in African children with acute nontraumatic coma
- Abstract:
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Background:
We explored the relationship between tympanic membrane displacement (TMD) measurements, a tool to monitor intracranial pressure noninvasively, and clinical features and death in children with acute coma in Kilifi, Kenya.
Methods:Between November 2007 and September 2009, we made serial TMD measurements and clinical observations on children with acute coma (Blantyre coma score (BCS) ≤ 2) on the pediatric high dependency unit of Kilifi District Hospital, and on well children presenting to the hospital’s outpatient department for routine follow-up. We examined middle ear function using tympanometry and measured cardiac pulse (CPA) and respiratory pulse pressure amplitudes (RPA) using the TMD analyzer.
Results:We recruited 75 children (32 (43%) females; median age 3.3 (IQR: 2.0, 4.3) years). Twenty-one (28%) children died. Higher TMD measurements predicted death. Adjusting for diagnosis, every 50 nl rise in both semirecumbent and recumbent CPA was associated with increased odds of death associated with intracranial herniation (OR: 1.61, 95% confidence interval (CI): 1.07, 2.41; P = 0.02 and OR: 1.35, 95% CI: 1.10, 1.66; P ≤ 0.01 respectively).
Conclusion:Raised TMD pulse pressure measurements are associated with death and may be useful in detecting and monitoring risk of intracranial herniation and intracranial pressure in childhood coma.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 620.3KB, Terms of use)
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- Publisher copy:
- 10.1038/pr.2015.57
Authors
- Funder identifier:
- https://ror.org/029chgv08
- Grant:
- 092654/Z/10/A
- Publisher:
- Springer Nature
- Journal:
- Pediatric Research More from this journal
- Volume:
- 78
- Issue:
- 1
- Pages:
- 38-43
- Place of publication:
- United States
- Publication date:
- 2015-03-19
- Acceptance date:
- 2014-12-12
- DOI:
- EISSN:
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1530-0447
- ISSN:
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0031-3998
- Pmid:
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25790276
- Language:
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English
- Pubs id:
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514900
- Local pid:
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pubs:514900
- Deposit date:
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2024-11-23
- ARK identifier:
Terms of use
- Copyright holder:
- Gwer et al
- Copyright date:
- 2015
- Rights statement:
- © 2015, The Author(s). This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material.
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