Klinische Pädiatrie
-
Klinische Pädiatrie · Jul 2009
Review Case ReportsTwo further cases supporting nonsurgical management in congenital lobar emphysema.
For decades, the well-established standard recommended treatment for patients with congenital lobar emphysema (CLE) and respiratory distress has been lobectomy of the affected lobe or lobes, whereas indications for conservative management have been controversially discussed. ⋯ Conservative treatment of children with congenital lobar emphysema is an attractive option, whenever justifiable on medical grounds. Our cases may serve as paradigms in decision-making processes in similar cases and - together with the literature review - may be helpful to avoid unnecessary lobectomies in children. Patients treated conservatively will need a close follow-up, and further data on long-term follow-up courses are desirable.
-
Klinische Pädiatrie · Jul 2009
Case Reports[Successful continuous renal replacement therapy in a neonate with early-onset group B streptococcal sepsis and multi-organ dysfunction syndrome].
Group B streptococcal early-onset sepsis (GBS EOS) in neonates has a mortality rate of approximately 5%, particularly in the presence of multi-organ dysfunction. Fluid management is crucial in these patients, and continuous venovenous haemofiltration (CVVH) should be considered a therapeutic option even in newborn babies. ⋯ Perinatal GBS-infections remain a major life-threatening event for newborn babies. CVVH should be considered an option for reversing fluid overload even in neonates with overwhelming SIRS. Alternatively, extracorporeal membrane oxygenation (ECMO) is discussed.
-
Klinische Pädiatrie · May 2009
[Development of a specialised paediatric palliative home care service].
In Germany annually 1,500-3,000 children die from life-limiting diseases. Symptoms and course of disease differ considerably depending on the character of the underlying disease. ⋯ Prospective aims are an area-wide professional supply of all paediatric palliative patients and the improvement of the cooperation with the resident paediatrician and paediatric palliative nursing services. Furthermore the establishment of networks as well as a proper communication among the professionals is inalienable.
-
Klinische Pädiatrie · Mar 2009
Infection rate with application of an antibiotic-impregnated catheter for shunt implantation in children - a retrospective analysis.
The infection rate of hydrocephalus shunts in children amounts figures of up to 25% and the according mortality rate is alarming high nowadays yet. An antibiotic impregnated shunt-catheter (AIS) was designed to reduce the incidence of shunt infections. ⋯ Apparently, AIS can reduce the incidence of shunt infections in children. Further prospective trials with a larger cohort are necessary for a statistically significant prove.
-
Klinische Pädiatrie · Mar 2009
Sepsis and lung abscess following malposition of an umbilical vein catheter in a neonate.
Umbilical vein catheterisation is a common and useful procedure in the care of critically ill newborns, but several complications may occur. ⋯ Our case highlights the importance of exact determination of the position of central catheters by x-ray and/or ultrasound immediately after placement.