ABSTRACT
The dysautonomic (DC) or neurovegetative crisis remains an imperfectly known entity; it associates in a paroxysmal manner a reaction of sympathetic hyperreactivity that can lead to the prognosis. Our objective is to specify the etiological circumstances (DC) and their modality of treatment in pediatric intensive care unit. MATERIALS-METHODS: Descriptive study on files of children admitted in the intensive care unit of 2010-2015 who presented a DC acquired during their hospitalization. RESULTS: In total, 41 patients included with an average age of 56.92 months presented DC. Among the etiological circumstances Guillain-Barré syndrome and head trauma are noted. Observed symptoms occur on average at one week of admission; they are related to the consequences of DC. The manifestations are polymorphic: a systolic hypertension is present in all cases with an average PAS of 141.24±13.48mmHg, an average PAD of 86.80±11.01mmHg, a vasomotor disorder, a hyperthermia are noted. Cerebral anoxia post cardiac arrest in 4 patients preceded the onset of DC. Apart from the etiologic treatment, 39 patients were intubated with mechanical ventilation, sedated with morphinomimetic and benzodiazepine±lioresal (baclofen). Treatment of hypertension resulted in the administration of a central antihypertensive. Evolution is good in addition to 5 deaths related to neurovegetative disorders. CONCLUSION: DC is a poorly understood situation in pediatric intensive care unit, and the circumstances of the disease are variable. The diagnosis must be made with careful consideration because the prognosis may be fatal.