Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2006
Comparative Study Clinical TrialArterial pulse wave analysis: An accurate means of determining cardiac output in children.
Cardiac output is a useful measure of myocardial performance. Standard methods of determining cardiac output are not without risk and can be problematic in children. Arterial pulse wave analysis (PulseCO), a novel, minimally invasive cardiac output determination technique, offers the advantage of continuous monitoring, convenience, and low risk. This technique has not been validated in children. The purpose of this study was to validate PulseCO as an accurate means of noninvasively determining real-time cardiac output in children. ⋯ Arterial pulse wave analysis by the PulseCO system provides a novel, minimally invasive method of determining real-time cardiac output in children.
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Pediatr Crit Care Me · Nov 2006
Urinary S100B concentrations are increased after brain injury in children: A preliminary study.
S100B is a renally excreted protein concentrated in glial cells of the nervous system. Increases in serum S100B concentrations reflect brain injury. However, increases in serum are rapid and transient and therefore may be of limited use in certain patients. Urinary S100B concentrations may be able to provide information about brain injury in this subgroup of patients. ⋯ Increases in urinary S100B are found in the majority of children with acute brain injury and an increased serum S100B. Urinary S100B concentrations peak later than serum concentrations, suggesting that measurement of urinary S100B may be helpful in subjects in whom early serum S100B is unavailable. Urinary and/or serum S100B concentrations may be useful to assist in the prediction of outcome after pediatric brain injury.
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Pediatr Crit Care Me · Nov 2006
Childhood obesity increases duration of therapy during severe asthma exacerbations.
Childhood obesity contributes to a wide array of medical conditions, including asthma. There is also increasing evidence in adult patients admitted to the intensive care unit (ICU) that obesity contributes to increased morbidity and to a prolonged length of stay. We hypothesized that obesity is associated with the need for increased duration of therapy in children admitted to the ICU with status asthmaticus. ⋯ Childhood obesity significantly affects the health of children with asthma. Obese children with status asthmaticus recovered more slowly from an acute exacerbation, even after adjustment for baseline asthma severity and admission severity of illness.
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Pediatr Crit Care Me · Nov 2006
ReviewOctreotide therapy for chylothorax in infants and children: A brief review.
We review physiology and pharmacology relating to the use of octreotide for chylothorax in infants and children. We review the published experience of octreotide dosing in this context. ⋯ Octreotide has been used as a successful therapeutic adjunct in a small number of neonatal cases and a larger number of pediatric cases. No consensus has been reached as to the optimal route of administration, dose, duration of therapy, or strategy for discontinuation of therapy. We suggest using higher doses (80-100 microg/kg/day) and initiating therapy early rather than using a low initial dose with upward titration. Duration of therapy required to elicit a significant response may vary between patients.