Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2004
Clinical TrialIncreases in serum levels of troponin I are associated with cardiac dysfunction and disease severity in pediatric patients with septic shock.
Myocardial cell injury may contribute to cardiac dysfunction in septic shock. Troponin I is a biochemical marker of myocardial cell injury and death. We hypothesized that troponin I is increased in pediatric patients with septic shock and correlates with cardiac dysfunction and disease severity. ⋯ Troponin I was increased in >50% of septic children early in their illness. Increased admission troponin I was associated with decreased measures of systolic cardiac function, as measured by echocardiography, and correlated with severity of illness. Early myocardial cell injury may contribute to the development of subsequent organ failure in septic shock, and measuring troponin I on admission may be helpful in assessing severity of sepsis.
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Pediatr Crit Care Me · Nov 2004
Clinical TrialPostoperative fluid balance influences the need for antihypertensive therapy following coarctation repair.
The purpose of the investigation was to determine the effect of fluid management on the need for perioperative antihypertensive therapy following coarctation repair. ⋯ A net positive fluid balance caused by either the volume of intraoperative crystalloid infusion or a lower urine output contributes to the development of paradoxic hypertension following coarctation repair regardless of patient age. Limiting intraoperative fluids and early diuretic use may limit the need for antihypertensive therapy and shorten the intensive care unit stay.
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Pediatr Crit Care Me · Nov 2004
Experience with mobile inhaled nitric oxide during transport of neonates and children with respiratory insufficiency to an extracorporeal membrane oxygenation center.
To share our experience with the use of inhaled nitric oxide (iNO) during the transport of ventilated neonates and children to an extracorporeal membrane oxygenation (ECMO) center and to discuss the efficacy and safety of iNO use in this situation. ⋯ iNO does appear to improve oxygenation during transfer of patients for ECMO in our series. Based on limited safety data, iNO appears safe to use in transport.
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Pediatr Crit Care Me · Nov 2004
Randomized Controlled Trial Clinical TrialFirst Pediatric Intensive Care Congress in Chile.
To summarize the First Chilean Congress on Pediatric Critical Care Medicine. DATA SOURCE/EXTRACTION: Program schedule, presentations, abstracts. ⋯ The Chilean Society of Pediatric Critical Care organized the First Pediatric Intensive Care Congress in Chile, having a registration of 217 delegates. All the pediatric intensive care units of the country had a representative in the Congress either as a delegate or a faculty member, which provided an excellent opportunity for interactions between them. The international faculty addressed state-of-the-art issues, with a charge of highlighting basic science relevant to clinical practice, which motivated long interactive question-and-answer sessions with the audience. Strong evidence was presented by Chilean faculty debaters who discussed controversial topics, making these sessions very attractive. An entire day was scheduled with a simultaneous nursing session. More than 80 intensive care nurses benefited from a very interactive day with five symposia and short oral presentations. A randomized multi-institutional research protocol studying reintubation rate using three methods for weaning from mechanical ventilation was discussed during the meeting. Thirteen units committed to participate. Twenty-three posters were displayed in the congress. Posters describing the activity of pediatric intensive care units were also presented. The mean for intensive care unit beds was 6.8 and for intermediate care beds was 7.1. Annual admissions showed a mean of 640 patients, and mortality rate ranged from 4.1% to 12%, with a mean of 6.7%
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Pediatr Crit Care Me · Nov 2004
Clinical TrialHeme oxygenase-1 messenger RNA expression is induced in peripheral blood mononuclear cells of pediatric cancer patients with systemic inflammatory response syndrome.
To determine whether heme oxygenase-1 messenger RNA expression in peripheral blood mononuclear cells is induced in pediatric cancer patients with the systemic inflammatory response syndrome (SIRS) and whether this expression correlates with the heme oxygenase-1 products, bilirubin and carboxyhemoglobin. ⋯ Heme oxygenase-1 messenger RNA, bilirubin, and carboxyhemoglobin levels were increased within 48 hrs of admission in pediatric cancer patients with SIRS. Heme oxygenase-1 expression correlated with serum bilirubin levels. The increase in heme oxygenase-1 expression may add to the understanding of the increase in serum bilirubin observed in patients with SIRS/sepsis. These findings support a role for heme oxygenase-1 in the physiologic response to inflammatory stress.