Pediatr Crit Care Me
-
Pediatr Crit Care Me · Jan 2003
Randomized Controlled Trial Clinical TrialErythropoietin therapy in children with bronchiolitis and anemia.
Critically ill children with bronchiolitis often require red blood cell transfusions. Anemia normally results in increased circulating erythropoietin concentrations; however, critical illness has been associated with a blunted erythropoietin response. Treatment with erythropoietin decreases the need for red blood cell transfusion in several disease states. We hypothesized that critically ill children with bronchiolitis and anemia would have a circulating erythropoietin deficiency and that treatment with exogenous erythropoietin would increase reticulocyte count and hematocrit and reduce red blood cell transfusion requirements. ⋯ Despite a favorable reticulocyte and circulating erythropoietin response, red blood cell transfusion requirements were not significantly diminished by erythropoietin treatment in children with bronchiolitis and respiratory failure. Erythropoietin cannot be routinely recommended for this patient population.
-
Pediatr Crit Care Me · Jan 2003
Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis.
To examine the relationships between procalcitonin, bacterial infection, sepsis-induced multiple organ failure, and mortality rate in children. ⋯ Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis. Further study is needed to better delineate this differential procalcitonin response to bacterial vs. nonbacterial sepsis and to characterize any mechanistic role that procalcitonin might play in the development of bacterial sepsis-induced multiple organ failure and mortality.
-
Pediatr Crit Care Me · Jan 2003
ReviewThe use of extracorporeal techniques to remove humoral factors in sepsis.
To determine whether there is sufficient evidence of a benefit of hemofiltration or plasma filtration in sepsis. ⋯ There is a lack of randomized trials. The available studies show an absence of benefit for hemofiltration. Further studies are needed in plasma filtration.
-
Pediatr Crit Care Me · Jan 2003
Case ReportsExtracorporeal life support as a treatment of supraventricular tachycardia in infants.
There have been few reports of the use of extracorporeal life support (ECLS) to provide cardiac support in children with low cardiac output as a result of arrhythmias. We present two patients in whom venoarterial ECLS was used to provide support for cardiogenic shock secondary to intractable supraventricular tachycardia. In both cases, the arrhythmia terminated once bypass was established. In one case, the time on ECLS was used to optimize drug treatment, and in the other case, radiofrequency ablation was successfully undertaken during ECLS.