Journal of pediatric surgery
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The aim of this report is to review a decade of experience in the management of perineal and genital burns at a major burn center. ⋯ Most perineal and genital burns in children can be treated successfully with a conservative approach. Child abuse should be vigorously investigated.
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Risk factors that may independently predict morbidity in children with penetrating abdominal wounds (PAW) have not been elucidated fully. The aim of this study was to identify not only correlated risk factors for morbidity in children with PAW, but also to evaluate the independent predictive value of 3 different trauma scoring systems: the Injury Severity Score (ISS), the Penetrating Abdominal Trauma Index (PATI), and the Pediatric Trauma Score (PTS). ⋯ ISS and PATI score were the most important indicators found to be independently associated with morbidity.
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Comparative Study
Delayed institution of extracorporeal membrane oxygenation is associated with increased mortality rate and prolonged hospital stay.
Severe meconium aspiration syndrome (MAS) is a frequent indication for extracorporeal membrane oxygenation (ECMO). Trials of less invasive cardiopulmonary support may result in fewer infants treated with ECMO but could delay institution of ECMO. The authors hypothesized that those infants with severe MAS who are treated with ECMO early will have a lower mortality rate and a shorter hospital course than those who receive delayed ECMO. ⋯ Delay in institution of ECMO for MAS results in prolonged ECMO and need for post-ECMO ventilation. Consideration should be given to instituting ECMO earlier in patients with severe MAS.
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The aim of this study was to characterize the perioperative complications of central venous catheter placement in children infected with human immunodeficiency virus (HIV) METHODS: A retrospective chart review was conducted of all central venous catheters placed by the surgical service into HIV-infected children from 1988 to 1998 at a large urban children's hospital. Complications occurring within 1 month of catheter placement were analyzed for several host and environmental factors. ⋯ The complication rate of central venous catheter placement into HIV-infected children is low (<15%), but is still higher than that of the general pediatric population. With careful preoperative preparation this procedure can be performed safely, even in patients with advanced HIV disease. J Pediatr Surg 36:1777-1780.
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Comparative Study
The incidence of septic complications in newborns on extracorporeal membrane oxygenation is not affected by feeding route.
The aim of this study was to compare the effects of enteral and total parenteral feeding on septic complications in neonates on extracorporeal membrane oxygenation (ECMO). ⋯ Enteral nutrition does not affect the risk of sepsis in neonates on ECMO when compared with total parenteral nutrition. Enteral nutrition is well tolerated and not associated with adverse effects.