Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)
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Practice Guideline
[Oxygen therapy in acute and chronic conditions: Indications, oxygen systems, assessement and follow-up].
Oxygen therapy has become a major tool for infants with acute and chronic respiratory failure. Appropriate goals when prescribing supplemental oxygen are reduction and prevention of hypoxemia, prevention and treatment of pulmonary hypertension and decrease in respiratory and cardiac overload. This is commonplace in the acute setting and is also becoming widespread in chronic pathologies. ⋯ The Techniques Group of the Spanish Society of Pediatric Pneumology undertook to design recommendations for a rational approach to oxygen therapy, reviewing the existing literature in order to establish its indications, benefits and potential risks as well as its cost-effectivenes. General aspects of oxygen treatment are reviewed including physiological mechanisms, indications, delivery systems and assessment methods. Management of patients on home oxygen therapy is also addressed with discussion of benefits and potential risks of supplemental oxygen use.
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Artificial Nutrition Support (ANS) is an important therapeutic technique in the care of the critically ill child that is not always implemented appropriately and correctly. There are also different ways of applying it which varies between the different centres and, even among the different health professionals. ⋯ Latin-American PICUs prefer enteral ANS administered by gastric feed soon after admission.
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To report our experience with non-invasive ventilation (NIV) after cardiac surgery. ⋯ NIV is effective and safe after cardiac surgery. It has very good results in respiratory failure due to atelectasis or pulmonary oedema. NIV failure in these patients is strongly associated with preoperative pulmonary sequelae secondary to heart disease. NIV indication in these patients has to be carefully evaluated.
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Catheter-associated bloodstream infection is highly prevalent and often associated with fatal complications. Some studies have shown that applying preventive interventions could help to reduce and control this type of infection. ⋯ A consensus protocol for the use and maintenance of central venous catheters and healthcare worker training helped to control the rate of CA-BSIs. We reaffirm the importance of epidemiological surveillance as a measure for controlling nosocomial infections.
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To describe the epidemiology of child abuse in an emergency department of a tertiary paediatric hospital. ⋯ We believe it is necessary to improve the pediatrician's knowledge of child abuse and to create specialized units.