Archives of disease in childhood
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Comparative Study Clinical Trial Controlled Clinical Trial
Use of pulse oximetry for blood pressure measurement after cardiac surgery.
Blood pressure measurement using pulse oximeter waveform change was compared with an oscillometric measurement and the gold standard, intra-arterial measurement, in children after cardiac surgery. Forty six patients were enrolled and divided into groups according to weight. Simultaneous blood pressure measurements were obtained from the arterial catheter, the oscillometric device, and the pulse oximeter. ⋯ The blood pressure measurements from the pulse oximeter method correlated better with intra-arterial measurements than those from the oscillometric device (0.77-0.96 v 0.42-0.83). The absolute differences between the pulse oximeter and intra-arterial measurements were significantly smaller than between the oscillometric and intra-arterial measurements in children less than 15.0 kg. The pulse oximeter waveform change is an accurate and reliable way to measure blood pressure in children non-invasively, and is superior to the oscillometric method for small patients.
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Randomized Controlled Trial Clinical Trial
Randomised controlled trial of sucrose by mouth for the relief of infant crying after immunisation.
To evaluate the effect of sucrose solution given by mouth on infant crying times and measures of distress in the immunisation clinic. ⋯ Infant immunisation by intramuscular injection is a distressing procedure for infants and parents. Sucrose solution at a high concentration reduces infant distress and is safe and clinically useful in this setting.
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To determine reference values for oxygen saturation (Sao2) in healthy children younger than 5 years living at high altitude. ⋯ This study has provided a reference range of Sao2 values for healthy children under 5 years old so that pulse oximetry may be used as an adjunct in diagnosing acute respiratory infections. Younger children were also shown to have a lower mean Sao2 than older children living at high altitude, which suggests physiological adaptation to high altitude over time. In addition, sleep had a lowering effect on Sao2, although the clinical importance of this remains undetermined.
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Letter Case Reports
Rapid response to isoflurane in refractory status asthmaticus.
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Multicenter Study
Procedures, placement, and risks of further abuse after Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation.
To investigate outcome, management, and prevention in Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. ⋯ This type of abuse is severe with high mortality, morbidity, family disruption, reabuse, and harm to siblings. A very cautious approach for child protection with reintroduction to home only if circumstances are especially favourable is advised. Paediatric follow up by an expert in child protection should also occur.