Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Comparative Study
[Respiratory distress in pediatric admission and emergency services. Epidemiology and evaluation criteria].
The medical part of the activity in the emergency units increased and has been ascribed to the raised number of infants or children admitted for acute dyspnea. This review is based on the published reports and the experience from the paediatric emergency unit from the Rouen area with 450,000 inhabitants, in France. We put forward the known epidemiological data and discussed the available means for the practitioner, which could help him in the decision to hospitalize. This review suggests that algorithms of treatment and severity evaluations must be set up in paediatric emergency units in order to validate them and specify the children who requires hospitalisation.
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Acute asthma attack in children is an attack responsible for life-threatening acute respiratory distress with partial or no response to bronchodilator drugs. The severity of the episode needs to be quickly evaluated. This presupposes a perfect knowledge of the clinical signs of severity. ⋯ Admission into the pediatric intensive care unit when bronchial obstruction continues will permit the association of bronchodilator drugs and the proposal of mechanical ventilation if needed. When the episode is resolved, a prophylactic treatment using inhaled corticosteroids must be prescribed. Clinical and spirometric follow-up has to be organized, and the patient and his/her family have to be educated.
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Case Reports
[Intravascular rupture of a central venous catheter in a premature infant: retrieval by a nonsurgical technique].
Central venous access is a frequent procedure in pediatric intensive care and neonatology. Catheter fracture with migration of the distal portion into the vessels is rare but may have side effects such as thrombosis. ⋯ This technique has avoided either delicate surgery or thrombotic risk due to a persistent intravascular foreign body. The authors prompted this interventional procedure within 36 hours after catheter migration in a center experienced in neonatal interventional catheterization.
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Forty cases of children with an inhaled foreign body (FB) are reviewed over a three-year period. Clinical data, radiologic findings and complications are detailed. The nature and size of FBs are also reported. ⋯ However, FB could be removed with the flexible bronchoscope in five children in our study. Diagnosis and removal of an inhaled FB are required as quickly as possible in order to prevent respiratory sequelae (bronchiectasis). Prevention is based upon information to be given to families, but to the medical community as well, which often minimizes the seriousness of inhalation hazards.