Articole semnate de acelasi autor in Revista Romana de Pediatrie:

DIAGNOSTICUL COMPUTER-TOMOGRAFIC IN URGENTA PEDIATRICA

Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 1, An 2014

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

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Promoting Global Health

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Cristina Coldea, Diana Stanescu, Mariana Coman, Dumitru Ferechide and Mihaela Balgradean

REZUMAT

Introducere. Examinarea prin computer-tomograf (CT) deţine un rol important în orientarea diagnostică în Urgenţă.

Obiective. Ne-am propus să identificăm utilitatea examinării CT, în urgenţa pediatrică.

Material şi metode. Studiul are un design cross-secţional, referindu-se la anul 2010. Din cele 92.959 de vizite înregistrate la Unitatea de Primiri Urgenţe, a Spitalului Clinic de Urgenţă pentru Copii „M.S. Curie“, Bucureşti, un număr de 9.258 pacienţi reprezentau urgenţe (lotul A), iar 90 constituiau urgenţe majore (lotul B). S-au efectuat un număr de 102 examinări CT. Datele au fost exprimate procentual.

Rezultate. Procentul de vizite asociat cu examinare CT, a fost de 1% în lotul A şi 1‰, exprimat global. Toţi pacienţii lotului B au fost supuşi investigaţiei CT. Principalele indicaţii au fost: traumatismele cranio-cerebrale (TCC) – 50%, hipertensiune intracraniană (HIC) – 35%, politraumatisme – 12,7% şi suspiciunile de malformaţii – 5,9%. Rata de detecţie globală a unei leziuni a fost de 51%. Pentru TCC, rata a fost de 49%, identificându-se următoarele leziuni: edem cerebral difuz (19%), hemoragii intracraniene (15,6%), fracturi osoase (15,6%), leziuni de părţi moi (29%). Pentru HIC, rata de detecţie a fost de 43%, pentru politraumatisme 84,6%, iar pentru suspiciunile de malformaţii 100%. Ratele de detecţie lezională, pe diverse categorii de indicaţii (senzitivitatea metodei) nu diferă semnificativ statistic faţă de alte studii.

Concluzie. La pacienţii de vârstă pediatrică, indicaţiile de CT, în urgenţă, s-au efectuat după o atentă selecţie a cazurilor, iar examinarea s-a dovedit utilă în cazul traumatismelor şi a suspiciunilor de hipertensiune intracraniană.

Cuvinte cheie: CT, urgenţă, traumatism, hipertensiune intracraniană

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Cristina Coldea

COMPUTED TOMOGRAPHY IMAGING IN THE PEDIATRIC EMERGENCY DEPARTMENT

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Cristina Coldea, Diana Stanescu, Mariana Coman, Dumitru Ferechide and Mihaela Balgradean

ABSTRACT

Introduction. The Computerised Tomography (CT) plays a crucial role in the emergency diagnosis.

Objective. Our purpose was to identify CT-scan’s utility in Pediatric Emergency Department.

Materials and methods. We used a cross-sectional approach, for the year 2010. From a total of 92959 visits in the Emergency Room (ER) of the “Clinical Emergency Hospital for Children “M.S. Curie”, Bucharest, 9258 patients were considered emergencies (group A) and 90 patients were major emergencies (group B). We performed 102 CT scans. Results were given as percents.

Results. The global percent of ER visits associated with a CT scan was 1% within the group A and it scored 1‰ from all ER visits. All patients from group B underwent a CT scan. Main indications were: major head injuries - 50%, intracranial hypertension – 35%, polytrauma – 12.7%, suspicions of malformations – 5.9%. The global detection rate for any kind of lesion was 51%. For brain trauma the rate scored 49%, identifying the following lesions: diffuse cerebral edema (19%), intracranial hemorrhage (15.6%), skull fractures (15.6%) and other facial or visceral lesions (29%). For intracranial hypertension the method’s sensitivity was 43%, for multiple trauma 84.6% and for malformations’ suspicions 100%. The lesions’ detection rate, for different clinical conditions (or the method’s sensitivity) is similar with other medical studies.

Conclusion. In all pediatric patients, indication of a CT scan was made after a careful selection of cases. The method proved to be useful for managing all kind of trauma and intracranial hypertension situations.

Keywords: CT, emergency, trauma, intracranial hypertension

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Cristina Coldea