The Journal of pediatrics
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The Journal of pediatrics · Aug 1995
Superior vena cava obstruction after extracorporeal membrane oxygenation.
Of 60 neonates who survived extracorporeal membrane oxygenation (ECMO) in our institution between June 1992 and March 1994, seven had either complete or partial superior vena cava (SVC) obstruction. When the patients with SVC obstruction were compared with those who had an echocardiogram after ECMO, no predisposing factors for the development of SVC thrombus could be found. Our data show that SVC thrombus may be a significant complication after ECMO.
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The Journal of pediatrics · Aug 1995
ReviewNew concepts in the treatment of children with acute respiratory distress syndrome.
Recent advances in mechanical ventilation, accompanied with a better understanding of the pathophysiology of ARDS, have resulted in a brighter outlook for the child who acquires this still dreaded disease. A greater understanding of the pathophysiology of ARDS has led to a heightened awareness that the care of these patients should be more than just supportive. The potential for exacerbation of lung injury by mechanical ventilation is real. ⋯ Centers with experience using ECMO in the setting of pediatric ARDS have better results than those where ECMO is infrequently used for this purpose. It is imperative that future studies of both mechanical ventilation and ECMO describe ventilation strategy and prospectively identify protocols or algorithms for ventilator management. Coupled with severity scores, ventilator techniques and ECMO can then be systematically compared in children with ARDS.
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The Journal of pediatrics · Aug 1995
Pitfalls in newborn hemoglobinopathy screening: failure to detect beta(+)-thalassemia.
Although universal newborn screening can reliably identify all infants with sickle cell hemoglobinopathies, the initial screening result must not be considered the definitive diagnosis. We describe 23 infants whose screening phenotype was FS or FC but whose true phenotype included hemoglobin A, establishing a definitive diagnosis of hemoglobin S or hemoglobin C in combination with beta(+)-thalassemia. Higher than expected hemoglobin concentrations or lower than expected mean erythrocyte volumes should suggest concurrent beta(+)-thalassemia.