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Linee guida trauma cranico pediatrico grave SIAARTI-SARNEPI

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J Neurosurg 1987; 67(6): 846-851<br />

Chronic syndrome of inappropriate<br />

secretion of antidiuretic hormone in<br />

a pediatric patient after <strong>trauma</strong>tic<br />

brain injury<br />

Ammuth CJ et al<br />

Arch Phys Med Rehabil 1993; 74(11):<br />

1219-1221<br />

compreso tra 3 e 8. L’introito calorico medio durante la<br />

prima settimana era di 725 kcal/die per gli adolescenti (11-<br />

17 anni) e di 340 kcal/die per i bambini (2-5 anni). Nella<br />

seconda settimana l’apporto calorico saliva a 1671 kcal/die<br />

per gli adolescenti e a 691 kcal/die per i bambini.<br />

L’escrezione media dell’azoto urinario era di 307 mg/Kg/die<br />

(adolescenti) e di 160 mg/Kg/die (bambini). Il calcolo del<br />

bilancio azotato medio degli adolescenti e dei bambini era<br />

di –13,6 e –4,1 rispettivamente. I livelli di albumina si<br />

riducevano da 2,9 g/dl (prima settimana) a 2,4 g/dl (seconda<br />

settimana). I livelli di proteine totali erano pari a 5,4 g/dl<br />

nella prima settimana mentre aumentavano a 6 g/dl nella<br />

seconda settimana.<br />

IV Viene descritto il caso di un paziente di 14 anni in cui si<br />

ebbe lo sviluppo di una SIADH in seguito ad un <strong>trauma</strong><br />

<strong>cranico</strong>. La restrizione dell’apporto di liquidi fu<br />

accompagnata ad una insufficiente apporto calorico. La<br />

normalizzazione dell’apporto calorico ed idrico si ebbe<br />

dopo la somministrazione di demeclociclina.<br />

Bibliografia<br />

1. Akkerdijsk WL et al Percutaneous endoscopic gastrostomy for patients with severe<br />

cerebral injury. Injury 1998; 29(1): 11-14<br />

2. Borzotta AP et al Enteral versus parenterale nutrition after severe close head injury. J<br />

Trauma 1994; 37(3): 459-468<br />

3. Carrillo EH et al Bedside percutaneous endoscopic gastrostomy. A safe alternative for<br />

early nutritional support in critically ill <strong>trauma</strong> patients. Surgical endoscopic 1997; 1078-71<br />

4. Charlin et al Protein and energy requirements in patients with severe head injury. Rev Med<br />

Chil 1993; 121(6): 626-632<br />

5. Fertl E et al Transient and long-term feeding by means of percutaneous endoscopic<br />

gastrostomy in neurological rehabilitation. Arch Phys Med Rehabil 1999; 80(4): 365-371<br />

6. Gauderer MW Percutaneous endoscopic gastrostomy-20 years later: a historical<br />

perspective. Pediatric Surg 2001; 36(1): 217-219<br />

7. Glaesener JJ et al Percutaneous endoscopic gastrostomy in the rehabilitation of<br />

neurological disorders. Schweiz Med Wochenschr 1992; 122(43): 1600-1605<br />

8. Grahm TW et al The benefits of early jejunal hyperalimentation in the head-injured<br />

patients. Neurosurg 1989; 25 (5): 729-735<br />

9. Kiel MK Does hyperalimentat improve outcome in patients with severe head injury? Arch<br />

Phys Med Rehabil 1994; 75(1): 116-117<br />

10. Klodell CT et al Routine intragastric feeding following <strong>trauma</strong>tic brain injury is safe and<br />

well tolerated. Am J Surg 2000; 179(3): 168-171<br />

11. <strong>Linee</strong> <strong>guida</strong> SINPE per la Nutrizione Artificiale Ospedaliera 2002, R.I.N.P.E., 2002, 4,<br />

168-170<br />

12. Marin OE et al Safety and efficacy of percutaneous endoscopic gastronomy in children.<br />

Am J Gastroenterol 1994; 89(3): 357-361<br />

13. Quilani R et al Peripheral plasma amino acid abnormalities in rehabilitation patients with<br />

severe brain injury. Arch Phys Med Rehabil 2000; 81(2): 176-181<br />

14. Stechmiller J et al Interruption of enteral feedings in head injured patients. Neurosc Nurs<br />

1994; 26 (4): 224-229<br />

15. Taylor SJ et al Prospective, randomized, controlled trial to determine the effect of early<br />

enhanced enteral nutrition on clinical outcome in mechanically ventilated patients suffering<br />

head injury. Crit Care Med 1999; 27(11): 2594-2595<br />

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