Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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During an hospitalization, a ten-day-old newborn infant was treated with ceftriaxone (Rocephine i.v., 390 mg/day) for an infection secondary to the presence of an umbilical catheter. A few minutes after the end of the fifth injection, the infant presented with cyanosis, initially localized at the perfusion site, then generalized, a tachycardia followed by acute circulatory failure with arterial hypotension and finally a multiple organe failure with coagulation, kidney and liver dysfunction. The infant received classical resuscitation treatment and recovered without short term sequelae. ⋯ A sensitization in utero or via breast feeding was ruled out due to the absence of maternal exposure to ceftriaxone. The absence of urticaria and bronchospasm, and the initial localization of cyanosis were not in favour of a classic allergic disease. An other cause, toxic or infectious cannot be ruled out.
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As a result of major progresses in anti-cancer treatment, many children with malignancy have to be admitted to an intensive care unit. Therefore it has become a necessity for paediatric oncologists and haematologists and paediatric intensive care physicians to work together. What are the current tools to guide their discussion and decision? There are few useful published studies about the outcome of oncology paediatric patients admitted to intensive care unit. ⋯ For each step, there is a need for a wide debate between oncologists, intensivists, nurses, psychologists, and the child's family in order to define the most consensual decisions. The development of validated prognostic scores for this particular population will be very helpful for the decision making. As frequently as possible the decision should be anticipated before the transfer of the child to the intensive care unit.
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Clinical Trial Controlled Clinical Trial
[Efficacy and safety of inhalation premixed nitrous oxide and oxygen for the management of procedural diagnostic pain in neuropediatrics].
We studied the use of premixed nitrous oxide and oxygen in 80 patients with neurologic diseases. ⋯ Premixed nitrous oxide and oxygen was effective for reducing procedural pain and anxiety in children with neurological disorders, even in severely handicapped patients, with minor side-effects.
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To determine the bacterial causal agents of meningitis and their pattern of resistance, in children more than one month to 14 years of age. ⋯ According to these data we may recommend the inclusion of vaccination against H. influenzae in the children immunization program in Madagascar. The early diagnosis and treatment with appropriate antibiotics, such as third generation of cephalosporins, are other critical measures to be taken in order to reduce the risk of developing severe complications associated to bacterial meningitis.