The Journal of pediatrics
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The Journal of pediatrics · Apr 1997
Infants with Kasabach-Merritt syndrome do not have "true" hemangiomas.
In 1940 Kasabach and Merritt described an infant with a vascular anomaly, extensive purpura, and thrombocytopenia; they called his lesion "capillary hemangioma." Hemangioma is a benign tumor that grows in infancy and is characterized by proliferation of endothelial cells and regression during childhood. Although Kasabach-Merritt syndrome (KMS) is frequently mentioned as a possible complication of hemangioma, our experience suggests that the anatomic vascular lesion underlying the thrombocytopenia is not a "true," classic, involuting type of hemangioma of infancy and childhood. ⋯ KMS is a distinctive disease of infancy, but the underlying vascular lesion is not a "true," classic, involuting type of hemangioma of infancy. This is a different vascular tumor with a resemblance pathologically to either tufted angioma or kaposiform hemangioendothelioma in association with lymphatic-like vessels. Whether the underlying lesion in KMS is a single anatomic entity or heterogeneous cannot be definitely concluded from this study. We need a better understanding of the pathogenesis of KMS to improve our therapeutic management.
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The Journal of pediatrics · Mar 1997
Femoral venous access is safe in burned children: an analysis of 224 catheters.
To document the incidence of septic and mechanical complications associated with femoral venous catheters in a subgroup of patients thought to be at particularly high risk of both: young children with large burns. ⋯ Femoral venous catheters are safe in burned children and are associated with a low incidence of infectious and mechanical complications.
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The Journal of pediatrics · Mar 1997
Inhaled nitric oxide enhances oxygenation but not survival in infants with alveolar capillary dysplasia.
A complex vascular abnormality in the lungs, termed alveolar capillary dysplasia (ACD) and misalignment of the lung vessels, has been recently recognized in some infants with persistent pulmonary hypertension. These infants die despite maximal medical support including extracorporeal membrane oxygenation (ECMO). Inhaled nitric oxide has been reported to improve oxygenation in neonates with persistent pulmonary hypertension of the newborn, and may allow some infants to avoid the need for ECMO. ⋯ This experience demonstrates that a short-term improvement after inhalation of nitric oxide does not lead to long-term survival in ACD. Further, in three infants the diagnosis of ACD was established by lung biopsy before death. Increasing awareness of this clinical entity may allow for the avoidance of costly, invasive procedures such as ECMO until more specific therapies become available.
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The Journal of pediatrics · Feb 1997
Randomized Controlled Trial Clinical TrialDexamethasone in salbutamol-treated inpatients with acute bronchiolitis: a randomized, controlled trial.
To determine the clinical benefit of oral dexamethasone in children admitted to the hospital with bronchiolitis treated with nebulized salbutamol. ⋯ Oral dexamethasone therapy does not affect the clinical course of children hospitalized with bronchiolitis and therefore cannot be recommended in this clinical situation.