Journal of pediatric surgery
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With the decrease of life-threatening obstructive upper airway infections and the ongoing improvement of intensive care medicine, the role of tracheostomy in children has been changing considerably, until now. The aim of this study was to establish data regarding indications, complications, and techniques of pediatric tracheostomy, which would reflect the current state of science. ⋯ The authors' research agreed widely with that in the literature. However, no tracheostomy-related death occurred. Possibly, this was because of their operative technique. In the opinion of the authors, establishing a cartilage window facilitates cannula exchange and reduces the risk of a fatal accidental decannulation.
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Review Case Reports
Primary cutaneous mucormycosis in infants and neonates: case report and review of the literature.
A case of angioinvasive cutaneous mucormycosis in a premature infant, eventually requiring extracorporeal membrane oxygenation therapy, is described. The fungal infection began at the site of a brachial artery catheter that had been covered with an adhesive dressing in the left antecubital fossa. The infection progressed rapidly over a 5-day period, and a left arm amputation was required. ⋯ Therapy consisted of local debridement and intravenous amphotericin B. High index of suspicion, early diagnosis, and rapid institution of therapy can improve survival rate. The key to prevention appears to be appropriate skin care.
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Comparative Study Clinical Trial
A prospective comparison of antibiotic usage in pediatric surgical patients: the safety, advantage, and effectiveness of the Surgical Infection Society guidelines versus a common practice.
The Surgical Infection Society (SIS) guidelines for antibiotic (Ab) usage minimally changed the surgical practice. The authors believed that clinical evidence of the safety, advantage, and effectiveness of SIS guidelines may improve inappropriate usage of Ab. ⋯ Perhaps these results may change Ab usage in pediatric surgery.
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Iatrogenic bronchial complications in intubated premature infants are rare. The authors present one case of rupture of a closed-tube endotracheal suction catheter. Clinical presentation was a persistent pneumothorax that required chest tube placement in several days. ⋯ No perforation was found. There are a few reports in the literature of iatrogenic bronchial complication in premature infants caused by closed-tube endotracheal suctioning catheters. Endobronchial rupture of this catheter has never been reported.
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Acute colonic pseudo-obstruction (ie, Ogilvie's syndrome) is an uncommon but serious condition in the pediatric population. Definitive management traditionally has consisted of endoscopic decompression. ⋯ To date, however, this literature has focused exclusively on the adult population. The authors present the first reported case of the successful administration of neostigmine to treat acute colonic pseudo-obstruction in a child.