Current opinion in pediatrics
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Drowning and immersion injuries are leading causes of mortality and morbidity in children. An increasing amount of epidemiologic information is available. ⋯ Efforts at early neurologic prognostication and identification of victims who are likely to die or persist in a vegetative state are increasingly accurate and are highly relevant. Critical care physicians are more likely to withhold or withdraw support from victims who have minimal likelihood of meaningful recovery.
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Advances in pediatric anesthesia can contribute to improved care of children in other environments. As an example, drugs and dosages established in preoperative sedation of children provide a base for their application in sedation and pain relief of children undergoing painful procedures in the emergency unit, oncology treatment area, and radiology suite. ⋯ Monitoring techniques may similarly be developed in the operating suite then applied in emergency areas or critical care units. We examine a qualitative device for detecting carbon dioxide in the exhaled gases of an intubated child.
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A wide range of topics can be covered when considering a review of respiratory therapeutics. This review focuses on advances and controversies in the therapy of asthma, including issues regarding medications such as inhaled beta 2-agonists, inhaled corticosteroids, cromolyn sodium, and theophylline. ⋯ Issues regarding surfactant therapy for respiratory distress syndrome remain prominent in the neonatal respiratory therapeutics literature and recent findings in this area are reported. Advances in the treatment of cystic fibrosis, as well as a review concerning the pulmonary toxicity of various medications used in the treatment of pediatric illness are discussed.