Paroxysmal Sympathetic Hyperactivity in Neurocritical Children: A Pilot Study.

Content Provider	Europe PMC
Author	Agrwal, Shipra Pallavi Jhamb, Urmila Saxena, Romit
Copyright Year	2022
Abstract	BackgroundParoxysmal sympathetic hyperactivity (PSH) is characterized by the abnormal excessive sympathetic response to acute cerebral insult. There is a paucity of data about this condition in children. This study was planned to analyze the incidence of PSH among children requiring neurocritical care and its association with the outcome.Materials and methodsThe study was conducted in the pediatric intensive care unit (PICU) of a tertiary care hospital over a period of 10 months. Children of age 1 month to 12 years admitted with neurocritical illnesses were included. Children who were declared brain dead after initial resuscitation were excluded from the study. The criterion laid by Moeller et al. was used for the diagnosis for PSH.ResultsDuring the study period, 54 children requiring neurocritical care were included in the study. The incidence of PSH was 5/54 (9.2%). Additionally, 30 (55.5%) children had less than four criteria for PSH and were termed as “incomplete PSH.” Children with all four criteria for PSH had a significantly longer duration of mechanical ventilation, PICU stay, and higher PRISM III scores. Children with less than four criteria for PSH also had a longer duration of mechanical ventilation and stay. However, there was no significant difference in mortality.ConclusionParoxysmal sympathetic hyperactivity is common in children with neurological illnesses admitted to the PICU and is associated with longer mechanical ventilation and stay in PICU. They also had higher illness severity scores. Timely diagnosis of the condition and appropriate management is required to improve the outcome of these children.How to cite this articleAgrwal S, Pallavi, Jhamb U, Saxena R. Paroxysmal Sympathetic Hyperactivity in Neurocritical Children: A Pilot Study. Indian J Crit Care Med 2022;26(11):1204–1209.
ISSN	09725229
Journal	Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine
Volume Number	26
PubMed Central reference number	PMC9983649
Issue Number	11
PubMed reference number	36873585
e-ISSN	1998359X
DOI	10.5005/jp-journals-10071-24346
Language	English
Publisher	Jaypee Brothers Medical Publishers
Publisher Date	2022-11-01
Access Restriction	Open
Rights License	© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.
Subject Keyword	Autonomic dysfunction Incomplete paroxysmal sympathetic hyperactivity Neurocritical illness Paroxysmal sympathetic hyperactivity Traumatic brain injury
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine