Saved by the Pupillometer! - A role for pupillometry in the acute assessment of patients with traumatic brain injuries?
Saved by the Pupillometer! - A role for pupillometry in the acute assessment of patients with traumatic brain injuries?
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DOI：
10.1080/02699052.2018.1429021
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发表时间：
2018-01-01
期刊：
影响因子：
1.9
通讯作者：
Myles, Lynn
中科院分区：
文献类型：
--
作者：
Emelifeonwu, John A.;Reid, Kirsten;Myles, Lynn
有充分的证据表明，瞳孔反应对于急性头部损伤的预测很有用。尽管如此，大多数瞳孔评估是主观的，并且由可能不是专家的医生进行。因此，它们可能不可靠。我们提出了一个病例的病人似乎不可逆转的死亡，从急性创伤性硬膜下血肿。这是通过评估他的瞳孔确定的，在到达神经外科手术室时，瞳孔对光无反应。他被转移到神经重症监护室进行脑干死亡测试，在那里通过客观瞳孔测量法评估确定他的瞳孔实际上是反应性的。在随后的手术清除硬膜下血肿后，他恢复良好。我们建议广泛采用客观的瞳孔计在急性颅脑损伤患者的评估，并提供我们的情况作为一个例子，如何客观和准确的评估可以使患者的结果有所不同。
There is good evidence that pupil reactivity is useful for prognostication in acute head injuries. Despite this, most pupil assessments are subjective and are performed by physicians who may not be experts. They can therefore be unreliable. We present a case of a patient with seemingly irreversible demise from an acute traumatic subdural haematoma. This was determined by assessment of his pupils, which were non-reactive to light at the time of arrival to the neurosurgical theatre. He was transferred to the neurointensive care for brainstem death testing, where assessment by objective pupillometry determined that his pupils were in fact reactive. He made a good recovery following subsequent surgery to evacuate his subdural haematoma. We propose the widespread adoption of objective pupillometers in the assessment of acute head-injured patients and offer our case as an example of how an objective and accurate assessment can make a difference to patients' outcome.