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Coma du nourrisson et de l’enfant : prise en charge initiale

Coma in infants and children: initial management

  • Revue / Review
  • Published:
Réanimation

Résumé

Le coma de l’enfant est un événement fréquent. Les étiologies sont dominées par les traumatismes crâniens (TC) et les infections neuroméningées, mais d’autres causes doivent être recherchées. Plus l’enfant est jeune, moins l’origine neurologique du coma est fréquente, avec un grand nombre de pathologies rares dont la prise en charge est très spécifique. Le pronostic est très variable en fonction de l’âge et de l’étiologie. L’approche du réanimateur doit être systématique et hiérarchisée afin d’orienter sa démarche thérapeutique en évitant la iatrogénie. Nous exposons les étiologies des comas de l’enfant (nouveau-né exclu), et proposons une conduite à tenir dans les premières heures aux urgences et en réanimation.

Abstract

Coma is a frequent condition in children, usually consecutive to trauma or neuromeningeal infection. Central nervous system aetiologies tend to be less frequent in infants, who may suffer from other rare specific diseases. Prognosis varies with the age and the underlying diseases. Intensivists should aim to diagnose both frequent and odd diseases as well as to administer emergent treatments without being iatrogenic. Here we describe the aetiologies of coma in children (newborns excluded) and present practical guidelines for initial patient management in the emergency room and intensive care unit.

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Authors and Affiliations

  1. Service de réanimation et surveillance continue pédiatriques, pôle de pédiatrie aiguë et médecine interne, hôpital Robert-Debré, Assistance publique-Hôpitaux de Paris et université Paris-Diderot-Paris-VII, 48, boulevard Sérurier, 75019, Paris, France

    P. Sachs, C. Michot, J. Naudin, C. Madre, S. Aizenfisz & S. Dauger

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  1. P. Sachs
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  2. C. Michot
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  3. J. Naudin
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  4. C. Madre
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  5. S. Aizenfisz
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  6. S. Dauger
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Correspondence to P. Sachs.

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Sachs, P., Michot, C., Naudin, J. et al. Coma du nourrisson et de l’enfant : prise en charge initiale. Réanimation 20, 408–418 (2011). https://doi.org/10.1007/s13546-011-0291-6

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  • DOI: https://doi.org/10.1007/s13546-011-0291-6

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