Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2003
Practice Guideline GuidelineGuidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Chapter 4. Resuscitation of blood pressure and oxygenation and prehospital brain-specific therapies for the severe pediatric traumatic brain injury patient.
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Pediatr Crit Care Me · Jul 2003
Randomized Controlled Trial Comparative Study Clinical TrialEffect of enalaprilat on postoperative hypertension after surgical repair of coarctation of the aorta.
Hypertension in pediatric patients after surgical repair of coarctation of the aorta can be difficult to control and may lead to morbidity. The renin-angiotensin system mediates at least part of this hypertension. Enalaprilat, the only intravenous angiotensin-converting enzyme inhibitor, is used to treat hypertension in pediatric patients in other settings. However, its effect on postoperative hypertension during the early postoperative period in patients undergoing surgical repair of coarctation of the aorta is unknown. ⋯ Conclusions are limited by a small cohort. Angiotensin-converting enzyme inhibitor therapy resulted in improved blood pressure control after coarctation repair. Further improvement of blood pressure control may be achievable by use of a larger dose of enalaprilat or a 4-hr enalaprilat-dosing interval.
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Pediatr Crit Care Me · Jul 2003
Comparative StudyDetection of traumatic brain injury with magnetic resonance imaging and S-100B protein in children, despite normal computed tomography of the brain.
The objective of this study was to obtain data to further define the extent of traumatic brain injury by using S-100B protein and standard noncontrast magnetic resonance imaging with added fluid-attenuated inversion recovery (FLAIR) and gradient echo sequence in children with normal head computed tomography. ⋯ Magnetic resonance imaging seems to be a useful modality to better define the spectrum of brain injury in children with mild head trauma. The addition of S-100B protein measurement does not seem to be useful in this setting.
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Pediatr Crit Care Me · Jul 2003
Linear and nonlinear analysis of heart rate variability during propofol anesthesia for short-duration procedures in children.
To determine whether heart rate variability metrics provide an accurate method of monitoring depth of anesthesia, assessing the response to painful stimuli, and assessing neuroautonomic regulation of cardiac activity in children receiving propofol anesthesia for short-duration procedures. ⋯ We conclude that power spectral analysis of heart rate variability may be an accurate and clinically useful measure of depth of propofol anesthesia. We speculate that high-frequency heart rate power during propofol anesthesia correlates with depth of anesthesia, whereas low-frequency power allows for assessment of the patient's sympathetic response to pain.