| dc.description.abstract | Information relating to twelve patients admitted into the Kenyatta National Hospital Intensive Care and High Dependency Units with a primary diagnosis of Hypoxic Brain Damage, was analyzed. The range of ages was from one-day-olds to adults and the length of stay within the units varied from one to nine days with an average stay of three days.
Eight (66.7%) of the patients were admitted from operating theatres within or outside of Kenyatta National Hospital, while the remaining four (33.3%) were from the casualty. All twelve patients were resuscitated prior to admission either as a result of cardiac arrest (33.3%) or respiratory arrest or failure (66.7%). The duration of resuscitation was only indicated in one (8.3%) of the cases with the duration of resuscitation being five minutes. On admission to the units, three (27.3%) of the patients were hypotensive, one patient (8.3%) was bradycardic and six patients (50.5%) were hypothermic.
Investigations done on the patients while in the units included arterial blood gases on all cases; random blood sugar in eleven cases (91.7%), hemoglobin levels in five cases (41.7%), serum sodium and potassium levels in ten (83.3%) and eleven (91.7%) cases respectively.Computer Tomography Scans of the brain were not done on any of the patients.
Neurological assessments were done on all the twelve patients on admission.
Ten (83.3%) of the patients had a Glasgow Coma Scale of 3 out of 15, one (8.3%) had a scale of 4 out of 15, one patient was not assessed as the patient was paralyzed and sedated with a neuromuscular blocking agent and a benzodiazepine
10
respectively. Pupillary light reflex assessment on admission revealed three patients (25%) had response to light while nine (75%) patients had no response to light. Of the latter, five (41.7%) had mid-dilated pupils and four (33.3%) fully dilated pupils.
Management of patients included antibiotic therapy and mechanical ventilation in eleven cases (91.7%), ionotropic support in one case (8.3%) and steroid therapy in four cases (33.3%).Eleven (91.7%) of the patients died while in the unit while one (8.3%) was transferred to the wards. An assessment for brain death was made in only four (33.3%) of the patients. | en_US |
