Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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The fact that some children may survive despite a limitation of treatment decision (LTD) made in the pediatric intensive care unit (PICU) is a recent concern. A previous study pointed out that the teams in charge of children after the PICU stay did not take previous PICU LTDs into account. ⋯ The medical reasoning model that is used for LTDs in the PICU generates conflictual situations when compared to the models that are used in other specialties. These models represent various expressions of subjectivity, as in any medical decision. Acknowledging this fact could facilitate its integration into clinical practice and should improve authentic debates that are necessary to ensure continuity of care for these children.
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The aim of this study was to investigate the use of psychotropic medications for both labeled and off-labeled indications in a French paediatric teaching hospital. ⋯ The high rates of off-label prescription documented here and elsewhere highlight the need for further controlled clinical trials to evaluate the risks and benefits of psychotropic medication in children and adolescents.
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Provide a descriptive analysis of children admitted to a tertiary care pediatric emergency department (PED) for a nasal foreign body (NFB) and describe the current knowledge and management of such accidents. ⋯ Often benign, this frequent accident can be serious in case of batteries or neodymium magnet insertion: the extraction becomes an emergency because of risks of nasal mucosa necrosis and/or nasal septum perforation. In other cases, positive pressure techniques (the parent's kiss or its variants) could be tried first in the emergency department or at home at the time of a call to emergency services before a medical visit.
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Even though ventilatory support for preterm infants has improved over the past few decades, about 30% of intubated preterm infants fail an extubation attempt. There are still no simple standards to determine the optimal extubation time for those infants. ⋯ As previously described, a low gestational age is a major factor predicting the extubation failure. However, our data suggests that ventilator settings and blood gas should also be considered when attempting extubation, following written guidelines.