Principles of Intensive Care in Children with Comas

Abstract

The paper presents data on current intensive care methods used in children with comas, which are based on the results of the authors’ own studies and on the data available in the literature. A hundred and fifty-eight children aged 2 to 14 years treated at the resuscitative and intensive care unit for comas of various genesis (hypoxic coma (n = 21), toxic coma (n = 42); cerebral circulatory disorders (n = 28), encephalitis (n = 11), and ketoacidotic coma (n = 56)) were followed up. The time course of changes in major biochemical parameters and free radical lipid peroxidation (FR LPO) was determined. All the patients were found to have significant metabolic disturbances — impaired acid-base balance and water-electrolyte balance, hypoxia and hyper- or hypocapnia, as well as FR LPO activation. In all types of coma, basic therapeutic measures were aimed at eliminating respiratory failure and hypoxia, making corrective and detoxification infusion therapies, sedation, and using neutropic agents. Intensive care is adequately corrected in accordance with the cause of come and with patients’ status.