Pediatrics
-
To determine whether episodes of prolonged hypoxemia occur without prolonged apneic pauses (> or = 20 seconds) and without bradycardia (pulse rate, < or = 100 beats per minute) in apparently well preterm infants. ⋯ These results indicate that a proportion of apparently well preterm infants exhibit episodes of severe prolonged hypoxemia unaccompanied by prolonged apneic pauses or bradycardia. Such episodes, therefore, would be difficult to detect if only breathing movements and heart rate are monitored. Indications for the use of oxygenation monitors in preterm infants should be reconsidered.
-
We performed this investigation to assess whether selective approaches to performing lumbar puncture (LP) in the early neonatal period will result in a missed or delayed diagnosis of bacterial meningitis. ⋯ If LPs are omitted as part of the early neonatal sepsis evaluation, the diagnosis of bacterial meningitis occasionally will be delayed or missed completely.
-
Clinical Trial Controlled Clinical Trial
A prospective, controlled evaluation of home chemotherapy for children with cancer.
Infusion of chemotherapy at home provides an alternative to hospitalization for children with cancer. Few programs of pediatric home chemotherapy have been described or evaluated. The purpose of this work was to compare prospectively chemotherapy in the hospital to chemotherapy at home with respect to billed medical charges, out-of-pocket expenses, and quality of life. ⋯ Administration of selected chemotherapy at home results in lower billed charges, reduced expenses, reduced loss of income for parents, and a more satisfying lifestyle for patients and parents.
-
Critically ill children often require endotracheal intubation before transport to a tertiary care center. Correct endotracheal tube (ETT) placement (trachea versus esophagus) and maintenance during transport are of the utmost importance. We evaluated a portable, qualitative, infrared end-tidal carbon dioxide monitor during transport of critically ill children. ⋯ We conclude that this carbon dioxide monitor was useful during transport of critically ill children in confirming ETT position. Further improvements in this noninvasive technology might be helpful in making the device more practical for use during interhospital transport.
-
Randomized Controlled Trial Clinical Trial
A randomized clinical trial of home intervention for children with failure to thrive.
To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive (NOFTT). ⋯ Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors. Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income, urban infants with NOFTT: Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT: