Indian pediatrics
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To present our institutional experience with prolonged dexmedetomidine (DEX) infusions in critically ill infants and children. ⋯ Prolonged DEX infusions were associated with a reduction in concomitant analgesia and sedation medications. DEX was well tolerated with the exception of heart rate, which decreased during the initiation of therapy but may not represent a clinically significant reduction.
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We analyzed the association between the day 1 glucose values in 209 children admitted to the PICU and the outcome (mortality). 58 (27.7%) children had hyperglycemia while 18 (8.6%) children had hypoglycemia, on day 1 after admission. Hypoglycemia was associated with higher mortality. This is contrary to the prevalent view supporting the association of hyperglycemia with poor outcome in the critically ill children.
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Chromobacterium violaceum is a rare pathogen that can cause potentially fatal infections in humans. Till date, 150 cases are reported worldwide including 7 from India. ⋯ Chromobacterium violaceum was isolated from blood, bone marrow aspirate and from skin lesions. Infant responded to treatment with piperacillin and ciprofloxacin, and is doing well on follow up.
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To examine occurrence of hyponatremia in critically ill children receiving conventional maintenance fluids (0.18% saline in 5% dextrose) and its relationship with electrolyte free water (EFW), sodium intake and natriuresis. ⋯ Fluid and sodium balance, magnitude of natriuresis and EFW intake alone did not explain occurrence of hyponatremia in critically ill children; contribution of other mechanisms needs to be studied.