Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2010
Randomized Controlled Trial Multicenter StudyCardiac arrhythmias associated with severe traumatic brain injury and hypothermia therapy.
Severe head trauma and/or severe hypothermia (< or =32 degrees C) can cause cardiac arrhythmias. Effect of moderate hypothermia (32-33 degrees C) on cardiac arrhythmias in children after severe traumatic brain injury is not well characterized. The objective is to determine the effect of moderate and short-term (24 hrs) hypothermia therapy on the incidence and severity of cardiac arrhythmias in children with severe traumatic brain injury compared with normothermic control subject using a 24-hr Holter recording. ⋯ Arrhythmias are frequent in severe pediatric traumatic brain injury. Further studies are needed to characterize the epidemiology and clinical impact of arrhythmias associated with severe pediatric head trauma and moderate hypothermia.
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Pediatr Crit Care Me · May 2010
Change in blood-brain barrier permeability during pediatric diabetic ketoacidosis treatment.
Cerebral edema is a devastating complication of pediatric diabetic ketoacidosis. We aimed to examine blood-brain barrier permeability during treatment of diabetic ketoacidosis in children. ⋯ Overall, whole brain and regional blood-brain barrier permeability increased in most subjects during diabetic ketoacidosis treatment. The frontal region had more blood-brain barrier permeability than other brain regions examined.
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Pediatr Crit Care Me · May 2010
Case ReportsOmphalocele and alveolar capillary dysplasia: a new association.
First report of an infant with coexistent omphalocele and alveolar capillary dysplasia. ⋯ This is the first description of an association between omphalocele and alveolar capillary dysplasia. In newborns with omphalocele who have severe respiratory insufficiency and pulmonary hypertension, alveolar capillary dysplasia should be considered.
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Pediatr Crit Care Me · May 2010
The motor response to stimulation predicts outcome as well as the full Glasgow Coma Scale in children with severe head injury.
To evaluate how well the full Glasgow Coma Scale and the motor response, which is a subscore of the Glasgow Coma Scale, predict the outcome in children who have sustained a traumatic brain injury. The best scores in the first 24 hrs were used. ⋯ Both the full Glasgow Coma Scale score and the motor response provide a useful indication of long-term outcome, although neither score is sufficiently accurate to be used to limit treatment. The full Glasgow Coma Scale does not have a linear relationship with mortality, and there is poor interobserver agreement. The motor response should be used in children in preference to the full Glasgow Coma Scale; the predictive power is equivalent to the full Glasgow Coma Scale, there is a linear relationship to mortality, and it is easier to collect accurately.
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Pediatr Crit Care Me · May 2010
Critical appraisal of: triaging pediatric critical care resources during a pandemic: ethical and medical considerations.
To identify the ethical norms that should govern the allocation of pediatric critical care resources during a pandemic. ⋯ Although research to develop such scoring systems is ongoing, clinicians will need to rely more heavily on individual diagnoses of acute illnesses with high mortality rates and underlying conditions with short life expectancies and on random allocation methods.