Archives of disease in childhood
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Functional adrenal insufficiency has been documented in critically ill adults. ⋯ Adrenal insufficiency is common in children with septic shock. It is associated with an increased vasopressor requirement and duration of shock.
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Randomized Controlled Trial Clinical Trial
Randomised controlled trial of aminophylline for severe acute asthma.
To determine whether children with severe acute asthma treated with large doses of inhaled salbutamol, inhaled ipratropium, and intravenous steroids are conferred any further benefits by the addition of aminophylline given intravenously. ⋯ Aminophylline continues to have a place in the management of severe acute asthma in children unresponsive to initial treatment.
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The aim of this study was to determine if children in the community with persistent cough can be considered to have asthma. A validated questionnaire was given to the parents of 1245 randomly selected children aged 6-12 years. ⋯ Although the syndrome commonly referred to as "cough variant asthma" could not be shown in this study, a significant number of children with persistent cough had been diagnosed as having asthma and were treated with asthma medications including inhaled corticosteroids. Studies are urgently needed to determine the appropriate treatment for children with persistent cough.
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To assess the risks and benefits of antibiotic treatment in children with symptoms of upper respiratory tract infection (URTI). ⋯ In view of the lack of efficacy and low complication rates, antibiotic treatment of children with URTI is not supported by current evidence from randomised trials.
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Comparative Study
Incidence of acute respiratory distress syndrome: a comparison of two definitions.
To determine the incidence and outcome of acute respiratory distress syndrome (ARDS) in children by comparing two commonly used definitions: the lung injury score and the American-European Consensus Conference definition. The causes and risk for developing ARDS were also studied. ⋯ Both definitions identified similar groups of patients. The incidence in this population was higher than that reported elsewhere, but mortality and cause were similar to those in developed countries. Poor outcome was associated with sepsis, a high admission PRISM score, and simultaneous occurrence of other organ dysfunction.