Journal of pediatric surgery
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Although the mortality, morbidity, and spectrum of associated injuries in children with pelvic fractures have been extensively studied, little is known about the functional outcomes in these patients. The authors examined retrospectively functional independence measurement (FIM) at discharge in children with pelvic fractures to determine how it should influence their management protocol. ⋯ Short-term function appears to be significantly impaired in a high percentage of children with stable and unstable pelvic fractures. Therefore, aggressive rehabilitation should be instituted early in all children with pelvic fractures to achieve optimal functional outcome.
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The isolated finding of free intraperitoneal fluid on abdominal computed tomography (CT) scan after blunt trauma in adults is considered an indication for laparotomy by many trauma surgeons. The authors wished to determine if these guidelines are applicable to children. ⋯ In contrast to adults, finding isolated free fluid on abdominal CT scans in children after blunt trauma does not dictate immediate surgical exploration.
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Abdominal compartment syndrome (ACS) is defined as cardiopulmonary or renal dysfunction caused by an acute increase in intraabdominal pressure. Although the condition is well described in adults, particularly trauma patients, little is known about ACS in children. ⋯ ACS is a potentially lethal complication of severe trauma and shock in children. To prevent the development of renal or cardiopulmonary failure in these patients, decompression should be considered for acute, tense abdominal distension.
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The objective of this study was to show the safety and efficacy of a method of percutaneous cannulation for venovenous extracorporeal life support (ECLS) access in nonneonatal (>10 kg) pediatric patients. ⋯ Percutaneous access may be used safely and effectively for venovenous ECLS in pediatric patients.