Pediatr Crit Care Me
-
Pediatr Crit Care Me · Jun 2015
Bedside Burr Hole for Intracranial Pressure Monitoring Performed by Pediatric Intensivists in Children With CNS Infections in a Resource-Limited Setting: 10-Year Experience at a Single Center.
Intracranial pressure monitoring can help in early identification of raised intracranial pressure and in setting more informed goals for treatment. We describe our 10-year experience of bedside burr holes performed by pediatric intensivists to establish intracranial pressure monitoring in children with CNS infections in a resource-limited setting and the technical difficulties and complications encountered. ⋯ In a resource-limited setting, pediatric intensivists can safely and successfully perform burr holes at bedside for establishing intraparenchymal intracranial pressure monitoring in children with acute CNS infections. However, our data do not support placement of ventriculostomy catheters by pediatric intensivists in similar settings.
-
Pediatr Crit Care Me · Jun 2015
Randomized Controlled Trial Multicenter StudySafety and Efficacy of Sodium Nitroprusside During Prolonged Infusion in Pediatric Patients.
Sodium nitroprusside is a direct-acting vasodilator used to lower blood pressure in the operating room and ICU. The efficacy of sodium nitroprusside has been analyzed in few pediatric randomized trials. This study assesses the efficacy and safety of sodium nitroprusside following at least 12 hours of IV infusion in children. ⋯ Sodium nitroprusside is efficacious in maintaining mean arterial blood pressure control in children following a 12-hour infusion. Although a high proportion of patients were found to have elevated cyanide levels, toxicity was not observed.
-
Pediatr Crit Care Me · Jun 2015
Glucocorticoid Receptor Expression in Peripheral WBCs of Critically Ill Children.
To characterize glucocorticoid receptor expression in peripheral WBCs of critically ill children using flow cytometry. ⋯ Our study suggests that patients with shock and increased severity of illness have lower glucocorticoid receptor expression in CD4 and CD8 lymphocytes. Glucocorticoid receptor expression does not correlate well with cortisol levels. Future studies could focus on studying glucocorticoid receptor expression variability and isoform distribution in the pediatric critically ill population as well as on different strategies to optimize glucocorticoid response.