Klinische Pädiatrie
-
Klinische Pädiatrie · Jan 1994
[Effectiveness and complications of percutaneous central venous catheters in neonatal intensive care].
Low birth weight babies and sick full-term babies, who require total parenteral nutrition and repeated intravenous applications of drugs, which irritate peripheral veins, very often need a reliable central venous catheter. The aim of our paper was to study prospectively the efficiency and the complications of peripheral percutaneous Silastic-catheters. ⋯ The mean duration of use was 13.7 days, the catheter-induced septicaemia-rate was 3.5%. We never saw serious complications of a central venous catheter, the most common complication was an intravasal central obstruction, but we found no relation between the occurrence-risk of complications, the duration of use and the infusion flow rate.
-
Klinische Pädiatrie · Sep 1993
Review[Stroke in the child: etiology, differential diagnosis, relevant diagnostic procedures and therapeutic possibilities].
Strokes in children occur in conjunction with arteriovenous malformations or with occlusive vascular diseases secondary to cardiac disease, intracranial infection, hematological and metabolic disorders. Recently several inborn errors of metabolism have been recognized as possible causes of strokelike events and should be considered in differential diagnosis. In a survey we describe our experience with stroke and strokelike episodes in childhood and discuss the approach selected for its management.
-
Klinische Pädiatrie · Jul 1993
[Results of treatment of primary exclusively pulmonary metastatic Ewing sarcoma. A retrospective analysis of 41 patients].
41 patients presenting with primary metastatic Ewing's sarcoma or malignant peripheral neuroectodermal tumor (PNET) with initial metastases restricted to the lungs and/or pleural space were analysed with respect to clinical manifestation and treatment results retrospectively. All patients were treated according to the protocols CESS 81 and CESS 86 of the German Society of Pediatric Oncology and Hematology (GPOH). The time since diagnosis ranges from 19 to 137 months, with a median of 72 months. ⋯ Cytostatic drug treatment was given according to the GPOH-CESS 81 and CESS 86 protocols. As calculated by means of the Kaplan-Meier analysis, relapse-free survival was 30% ten years after diagnosis. Surgery or pulmonary irradiation of 12-20 Gy was applied to lung metastases. 12 of 27 patients are in continuous complete remission following this therapeutic approach.
-
Klinische Pädiatrie · Jul 1993
Comparative StudyCeftriaxone alone or in Combination with Teicoplanin in the Management of Febrile Episodes in Neutropenic Children and Adolescents with Cancer on an Outpatient Base.
This study prospectively investigated the outpatient once daily therapy with ceftriaxone alone or if necessary in combination with teicoplanin, in the treatment of infections in children and adolescents with chemotherapy-induced neutropenia or aplastic anemia. ⋯ There were 64 febrile episodes in 42 patients. Single agent once daily broad spectrum cephalosporin was adequate in 43/64 (67%) of infectious episodes in neutropenic patients. For persisting or increased fever or CRP elevation, 9 patients were treated with ceftriaxone and teicoplanin successfully. Thus hospitalized was avoided in 52/64 (81%) of infectious episodes.
-
Klinische Pädiatrie · May 1993
Randomized Controlled Trial Clinical Trial[Effect of body position and positioning changes on lung function of ventilated premature and newborn infants].
We studied 21 intubated premature infants (wts 800-2800 g) with respiratory distress syndrome between day 2 and 10 to evaluate the effect of body position on lung mechanics and gas exchange. The dynamic compliance of the total respiratory system was similar in the prone and supine position. ⋯ Positioning did not significantly affect the dynamic compliance, the minute volume or pCO2. In circulatory stable premature infants a change of the body position probably alters the regional ventilation to perfusion ratio and leads to a reduction of intrapulmonary venous admixture.