Journal of pediatric surgery
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In children, persistent air leaks can result from pulmonary infection or barotrauma. Management strategies include surgery, prolonged pleural drainage, ventilator manipulation, and extracorporeal membrane oxygenation (ECMO). We report the use of endobronchial valve placement as an effective minimally invasive intervention for persistent air leaks in children. ⋯ Endobronchial valve placement for prolonged air leaks owing to a variety of etiologies was effective in these children for treating air leaks, and their use may result in resolution of fistulae and avoidance of the morbidity of pulmonary surgery.
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Biography Historical Article
Arnold Salzberg, HB, MD: The Pied Piper of MCV.
Salzbergian\solz-bərgē-ən\ adjective of, relating to, or following the teachings of Arnold Salzberg. Noun one who embodies all that Arnold Salzberg taught about humanity. Noun one who has obtained his or her HB degree. ⋯ These might be the words that are used, but many times words cannot do justice to describing something so special. Arnold Salzberg was many things to many different people, "father figure," "wonderful advisor and resource," "ultimate mentor," "humanitarian," but when he was asked how he wanted to be remembered, he simply smiled and replied, "Icon…that would be nice." Never at a loss for words or humor and forever with an open door to his office, home, and heart, Dr. Salzberg embodied what so many medical students, residents, and attendings have been striving for, the ideal combination of physician and human being.
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Beginning in 2003, the pediatric emergency medicine (PEM) physician replaced the surgeon as the team leader for all level II trauma resuscitations at a busy pediatric trauma center. The purpose was to review the outcomes 10 years after implementing this practice change. ⋯ We conclude that level II trauma resuscitations can be safely evaluated and managed without immediate surgeon presence. Although ED LOS increased, admission rate and CT scan usage decreased significantly without an increase in missed injuries.
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Excessive crystalloid resuscitation of blunt injured adults is deleterious. We hypothesize that children, unlike adults, are resistant to the adverse effects of high volume resuscitation. ⋯ Excessive crystalloid resuscitation was associated with increased hospital LOS and need for mechanical ventilation. Increased rates of other complications including ARDS, ACS, and MOF were not observed. Injured children appear relatively resistant to some of the adverse effects of early high volume fluid resuscitation.
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Randomized Controlled Trial
Single shot intercostal block for pain management in pediatric patients undergoing the Nuss procedure: a double-blind, randomized, controlled study.
The aim of this study was to investigate the efficacy of a single shot intercostal block for pain control in pediatric patients undergoing the Nuss procedure. ⋯ A single shot IB is an effective additional treatment for pediatric patients undergoing the Nuss procedure and results in the reduced consumption of morphine, less postoperative pain, and fewer opioid-related adverse effects.