Haemodynamic support at children with severe traumatic brain injury

Abstract

Severe traumatic brain injurie is one of the most burning issues of modern pediatric intensive care as extent of restoration of function of the central nervous system depends on success of treatment. Despite existence of a many number of pilot studies, there is no consensus about the most effective and safe medicine for hemodynamic support at children with a severe traumatic brain injury now. In clinical practice are most often used dopamine and dobutamine which appointment is not always justified. The review of the works devoted to efficiency of use of various vasoactive drugs is presented in article. On the basis, of the carried-out analysis it is possible to draw the following conclusions: 1. Medicine of the first line for correction of hemodynamic disturbances at children with traumatic brain injury without symptoms of the proceeding bleeding is dopamine. 2. In the presence of acute massive blood loss, severe arterial hypotension and symptoms of the proceeding bleeding medicine of the choice is noradrenaline. 3. The isolated application of a dobutamine for children with a severe traumatic brain injury should be avoided owing to potentially possible decrease in cerebral perfusion pressure.