Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Nov 2004
Intravenous amiodarone bolus for treatment of atrial fibrillation in patients with advanced congestive heart failure or cardiogenic shock.
The clinical course of patients with advanced organic heart disease is often complicated by the occurrence of atrial fibrillation. Slowing the ventricular rate and, if possible, restoration of normal sinus rhythm is crucial but difficult in the state of decreased ventricular function. ⋯ Amiodarone, given as a single intravenous bolus through a peripheral vein rapidly reduced ventricular rate and was well tolerated in patients with atrial fibrillation, even in the presence of congestive heart failure and cardiogenic shock.
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Wien. Klin. Wochenschr. · Nov 2004
Case ReportsSuccessful treatment of ARDS and severe pulmonary hypertension in a child with Bordetella pertussis infection.
Infection with Bordetella pertussis can cause severe illness with neurological and pulmonary complications in children. Pulmonary hypertension is an early sign of potentially fatal disease and can cause failure of conventional respiratory therapy in severe acute respiratory distress syndrome (ARDS). We report a 4 1/2-year-old boy with B. pertussis infection who developed severe ARDS and pulmonary hypertension. ⋯ After conventional ventilation, surfactant and high frequency oscillation ventilation (HFOV) failed, treatment with nitric oxide (NO) improved oxygenation, allowing recovery without the need for ECMO. The patient survived with few sequelae. Thus, this treatment may be an option in high-risk children who meet the criteria for ECMO but are excluded because of poor neurological status, as in our patient.