Pediatr Crit Care Me
-
Pediatr Crit Care Me · Sep 2005
Pneumococcal meningitis in a pediatric intensive care unit: prognostic factors in a series of 49 children.
Despite advances in antibiotic therapy strategies and in pediatric intensive care, prognosis of Streptococcus pneumoniae meningitis remains very poor. However, few prognostic studies have been published, especially in pediatric populations. ⋯ S. pneumoniae meningitis remains a devastating childhood disease in developed countries. Three variables were independently associated with the in-hospital death in our series-high Pediatric Risk of Mortality II score, low white blood cells count, and low platelet count-reflecting the main importance of severe sepsis and neurologic presentation in establishing the prognosis of these patients.
-
To describe a patient who had been taking ibuprofen for 3 days before the diagnosis of a massive pulmonary embolus without hypoxemia. ⋯ The absence of hypoxemia (including a normal alveolar-arterial oxygen difference) in our patient with a massive pulmonary embolus may have been related to cyclooxygenase inhibition due to ibuprofen, with improvement in ventilation-perfusion mismatch.
-
Pediatr Crit Care Me · Sep 2005
Sleep and adverse environmental factors in sedated mechanically ventilated pediatric intensive care patients.
To document the quantity and architecture of sleep using objective electrophysiologic assessment in sedated mechanically ventilated pediatric intensive care unit patients over a 24-hr period and to investigate the effect of noise and staff interventions on sleep pattern in these subjects. ⋯ The above findings suggest a significant electrophysiologic abnormality of sleep in the pediatric intensive care unit patients. Our pediatric intensive care unit environment is characterized by both, high noise levels and frequent staff interventions. This study has several limitations and future studies are needed, with larger sample size and an attempt to manipulate the environmental factors to minimize their negative effects on sleep.