Abnormal Intra-aural Pressure Waves Associated with Death in African Children with acute Nontraumatic Coma.

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dc.contributor.authorGwer, S.
dc.contributor.authorKazungu, M.
dc.contributor.authorChengo, E.
dc.contributor.authorOhuma, E. O.
dc.contributor.authorIdro, R.
dc.contributor.authorBirch, T.
dc.contributor.authorMarchbanks, R.
dc.contributor.authorKirkham, F. J.
dc.contributor.authorNewton, C. R.
dc.date.accessioned2015-07-08T07:27:32Z
dc.date.available2015-07-08T07:27:32Z
dc.date.issued2015
dc.descriptiondoi: 10.1038/pr.2015.57en_US
dc.description.abstractBACKGROUND: 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.en_US
dc.identifier.citationPediatr Res. 2015 Jul;78(1):38-43en_US
dc.identifier.issn0031-3998
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/pubmed/25790276
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/13120
dc.language.isoenen_US
dc.publisherNature Publishing Groupen_US
dc.titleAbnormal Intra-aural Pressure Waves Associated with Death in African Children with acute Nontraumatic Coma.en_US
dc.typeArticleen_US
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