Journal of pediatric surgery
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Partial liquid ventilation (PLV) has been shown to improve oxygenation and lung mechanics in different models of acute lung injury. This study was designed to investigate the effects of 2 gas ventilatory strategies during PLV on gas exchange, respiratory mechanics, and hemodynamics in acute lung injury in piglets. ⋯ The results of this pilot study suggest that oxygenation was equally improved during PLV. This effect was independent of the mode of gas ventilation. However, the high PEEP-moderate Vt gas ventilatory technique resulted in moderate hypercapnia.
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Review Case Reports
A complication associated with central line removal in the pediatric population: retained fixed catheter fragments.
There are many reports on the complications that occur at the time of insertion and during the life of central venous indwelling catheters. However, there is no literature that describes the complications that occur at the time of removal of these lines. ⋯ This review identifies a specific problem that can occur with central line removal. Both the long-term affects of residual catheter within the central venous system and the need to remove the foreign body have yet to be addressed.
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Review Case Reports
Repeated surgical excision for an unusual variant of nephroblastoma: case report and review of the literature.
Bilateral fetal rhabdomyomatous nephroblastoma is a rare variant of Wilms' Tumor. The authors report the evolution over 48 months of a 10-month-old baby with bilateral nephroblastoma for which a left nephrectomy was initially performed. ⋯ The transformation of the primary tumor into a completely differentiated cystic nephroblastoma or nephromalike tumor and the appearance of a metachronous lesion was seen. This report emphasizes the role of nephron-sparing surgery in bilateral Wilms' Tumor when a benign transformation occurs under chemotherapy.
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Assessment of potential spine injuries is inconsistent and controversial. Subsequent morbidity includes prolonged immobilization and missed injuries. To address these issues, a multidisciplinary team was organized to design a cervical spine management/clearance pathway. The process, algorithm, and initial results are described. ⋯ standards for cervical spine immobilization, assessment, and clearance. Implementation of such guidelines decreased time for cervical spine clearance, and ongoing analysis of sensitivity is encouraging.