Posterior Reversible Leukoencephalopathy Syndrome (PRES) in Intensive Care Unit - Case series.
Posterior Reversible Leukoencephalopathy Syndrome (PRES) in Intensive Care Unit - Case series.
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DOI：
10.4103/ijccm.ijccm_235_17
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Manhas Y
中科院分区：
文献类型：
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作者：
Gokhale A;Kimona A;Kantor S;Prakash S;Manhas Y
后部可逆性脑病综合征(PRES)以一系列临床神经放射学表现为特征，并伴有各种病因引起的高血压。与它的名字相反，一小部分患者有残留的神经缺陷。有严重PRES表现的患者可能会因昏迷或癫痫持续状态而进入重症监护病房(ICU)。已经报道了小病例系列和大的多中心研究。我们报告了一个单中心系列，在一个三级护理中心的5年时间里，有10个病例住进了ICU。我们回顾分析了因不同原因住进成人ICU的患者，并诊断为PRES。记录出院时和入院后90天的结果。最常见的病因是药物。ICU的入院原因主要是无法控制的高血压、癫痫发作和意识水平低下。除一名患者外，其余患者均接受了呼吸机治疗。4名患者有残留的神经损伤。无论病因如何，及早控制血压和排除诱发因素对预防发病率和死亡率至关重要。强化症患者对PRES的认识是必要的，以确保早期识别和治疗。
Posterior reversible encephalopathy syndrome (PRES) is characterized by a range of clinico neuro radiological manifestation along with hypertension due to varied etiology. Contrary to its name, a small number of patients have residual neurological deficits. Patients with severe manifestation of PRES may get admitted to the Intensive Care Unit (ICU) due to coma or status epilepticus. Small case series and large multicenter studies have been reported. We report a single center series of ten cases admitted to ICU over a 5 year period in a tertiary care centre. We retrospectively analyzed patients, admitted to adult ICU with different etiologies, and diagnosed to have PRES. Outcome at discharge and at 90 days after ICU admission was noted. The most common etiologies were medications. ICU admissions were mainly for uncontrolled hypertension, seizures, and low level of consciousness. All except one patient were ventilated. Four patients had residual neurological damage. Irrespective of the etiology, early control of blood pressure, and removal of precipitating factors is of paramount importance to prevent morbidity and mortality. Awareness about PRES among the intensivist is necessary to ensure early recognition and treatment.