Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2002
Noninvasive ventilation in the treatment of acute respiratory failure induced by all-trans retinoic acid (retinoic acid syndrome) in children with acute promyelocytic leukemia.
To evaluate the feasibility of noninvasive ventilation through a nasal mask in the treatment of acute respiratory failure induced by all-trans retinoic acid. ⋯ Noninvasive ventilation by a nasal mask can offer effective ventilatory support and improve gas exchange in the treatment of acute respiratory failure in pediatric hematologic patients. In addition, noninvasive ventilation may decrease the risk of life-threatening complications associated with endotracheal intubation and conventional mechanical ventilation in patients with hematologic malignancies.
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Pediatr Crit Care Me · Jan 2002
Detection of pepsin and glucose in tracheal secretions as indicators of aspiration in mechanically ventilated children.
The detection of glucose in tracheal secretions has been used as an indicator of aspiration in mechanically ventilated, tube-fed children. Pepsin detection may be a more specific indicator. We determined the frequency of pepsin and glucose detection in tracheal secretions of mechanically ventilated children and studied the relationships between tracheal secretion pepsin and glucose and clinical evidence of gastroesophageal reflux. ⋯ Pepsin is detectable in tracheal secretions of mechanically ventilated children at risk for aspiration. Elevated glucose concentrations in tracheal secretions can occur by mechanisms other than aspiration of glucose-rich formula. Pepsin may be a more specific marker for aspiration than glucose.
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Pediatr Crit Care Me · Jan 2002
Treatment and toxicokinetics of acute pediatric arsenic ingestion: danger of arsenic insecticides in children.
To describe the toxicokinetics and management of acute pediatric arsenic ingestion. ⋯ Recovery from arsenic poisoning was attributable to the restoration and maintenance of adequate cardiac output and renal perfusion in early shock, which allowed depot intramuscular British anti-Lewisite to circulate and eliminate the poison. Although an intravenous antiarsenical chelating agent would be advantageous in treating shock from arsenic poisoning, none is currently available. We urge the immediate use of British anti-Lewisite therapy on patient presentation with suspected toxic arsenic ingestion.
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Pediatr Crit Care Me · Jan 2002
Cerebrospinal fluid procalcitonin and severe traumatic brain injury in children.
To determine the relationship between cerebrospinal fluid procalcitonin concentration and severe traumatic brain injury in children. ⋯ Cerebrospinal fluid procalcitonin concentration is increased in children after traumatic brain injury. The attenuated increase in cerebrospinal fluid procalcitonin among victims of abusive head trauma warrants further study because it may reflect impairment of endogenous neuroprotective mechanisms or delay in seeking medical attention. The significance of these observations remains to be determined as future studies elucidate the physiologic and mechanistic properties of procalcitonin.
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Measuring outcome in pediatric intensive care is necessary to equate the high cost of treatment with benefits to the patient. Although mortality rates and morbidity are relatively insensitive measures of the benefits of treatment, quality of life measurement gives insight into the long-term outcomes. The aim of this study was to investigate the long-term quality of life outcome of children admitted to a pediatric intensive care unit. ⋯ Our results indicate that the long-term outcome in terms of quality of life after admission to a pediatric intensive care unit is good or normal for the majority of surviving children. Those children with a poor outcome are likely to have significant comorbidities or a diagnosis of malignancy.