The Journal of pediatrics
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The Journal of pediatrics · Jun 1995
Randomized Controlled Trial Comparative Study Clinical TrialA randomized trial comparing the efficacy of epinephrine with salbutamol in the treatment of acute bronchiolitis.
This randomized, double-blind trial compared the efficacy of nebulized epinephrine with salbutamol in the treatment of infants with acute bronchiolitis. The mean percent oxygen saturation at 60 minutes was significantly higher in the epinephrine group. Thirty-three percent of the patients in epinephrine group were admitted to the hospital compared with 81% of the salbutamol group (p = 0.003). We conclude that nebulized epinephrine is more efficacious than salbutamol for infants with acute bronchiolitis seen in an emergency department.
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The Journal of pediatrics · Jun 1995
Clinical TrialRisk of recurrent stroke in patients with sickle cell disease treated with erythrocyte transfusions.
To determine the effect of a transfusion program on risk of stroke recurrence in children with sickle cell disease. ⋯ We conclude that maintenance of hemoglobin S at a level less than 30% appears to be effective in reducing the rate of recurrent infarction but does not prevent transient neurologic events. Transient neurologic events are common but do not appear to be related to recurrent stroke.
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The Journal of pediatrics · Jun 1995
Comparative StudyEconomic comparison of a tissue adhesive and suturing in the repair of pediatric facial lacerations.
To determine, from the societal perspective, the most cost efficient of the three methods commonly used to repair pediatric facial lacerations: nondissolving sutures, dissolving sutures, or a tissue adhesive (Histoacryl blue). ⋯ Tissue adhesive is the preferred method of closure of pediatric facial lacerations because it results in the most efficient use of resources and is preferred by the majority of parents.
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The Journal of pediatrics · Jun 1995
Coagulation factor deficiencies during initiation of extracorporeal membrane oxygenation.
We examined the hypothesis that critically ill patients receiving extracorporeal membrane oxygenation (ECMO) have reduced clotting factor levels, which may contribute to the risk of hemorrhagic complications. ⋯ Severe coagulation factor deficiencies are often present in patients requiring ECMO, and coagulation factors provided through the circuit prime are insufficient to ensure correction of these deficiencies. Deficiency of multiple coagulation factors may contribute to the risk of intracranial hemorrhage during ECMO; the practice of excluding factor-containing solutions from the circuit prime should be examined prospectively.
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The Journal of pediatrics · Jun 1995
Effect of airway pressure on inferior vena cava pressure as a measure of central venous pressure in children.
We evaluated the effect of elevated airway pressure on the validity of intravascular pressure obtained in the distal inferior vena cava (IVC) as a measure of central venous pressure (CVP) in a group of children receiving mechanical ventilation. The IVC pressure correlated well with CVP in the patients without abdominal distention, but the disparity was wider in those with abdominal distention. Elevated mean airway pressure or positive end-expiratory pressure had no effect on the relationship of IVC to CVP.