Pediatr Crit Care Me
-
Pediatr Crit Care Me · Jul 2014
Observational StudyPopulation Pharmacokinetics of Unbound Hydrocortisone in Critically Ill Neonates and Infants With Vasopressor-Resistant Hypotension.
To determine the population pharmacokinetics of unbound hydrocortisone in critically ill neonates and infants receiving IV hydrocortisone for treatment of vasopressor-resistant hypotension and to identify patient-specific sources of pharmacokinetic variability. ⋯ We report the first pharmacokinetic data for unbound hydrocortisone, the pharmacologically active moiety, in critically ill neonates and infants with vasopressor-resistant hypotension. Unbound hydrocortisone clearance increased with body weight and was faster in children with an older postmenstrual age. Unbound hydrocortisone clearance increased sharply at 35 weeks postmenstrual age and continued to mature thereafter. This study lays the groundwork for evaluating unbound hydrocortisone exposure-response relationships and drawing definitive conclusions about the dosing of IV hydrocortisone in critically ill neonates and infants with vasopressor-resistant hypotension.
-
Pediatr Crit Care Me · Jul 2014
Use of Rotterdam CT Scores for Mortality Risk Stratification in Children With Traumatic Brain Injury.
The Rotterdam CT score refined features of the Marshall score and was designed to categorize traumatic brain injury type and severity in adults. The objective of this study was to determine whether the Rotterdam CT score can be used for mortality risk stratification after pediatric traumatic brain injury. ⋯ Children with traumatic brain injury have better survival than adults in Rotterdam CT score categories representing less severe injuries but worse survival than adults in higher score categories. A novel, validated pediatric mortality model based on the Rotterdam score is accurate in children with moderate or severe traumatic brain injury and can be used for risk stratification.
-
Pediatr Crit Care Me · Jul 2014
Comparative StudyAdrenaline, Terlipressin, and Corticoids Versus Adrenaline in the Treatment of Experimental Pediatric Asphyxial Cardiac Arrest.
To analyze if treatment with adrenaline (epinephrine) plus terlipressin plus corticoids achieves higher return of spontaneous circulation than adrenaline in an experimental infant animal model of asphyxial cardiac arrest. ⋯ Treatment with adrenaline plus terlipressin plus corticoids does not achieve higher return of spontaneous circulation than that with adrenaline in an infant animal model of asphyxial cardiac arrest.
-
Pediatr Crit Care Me · Jul 2014
Evaluation of Dexmedetomidine and Postoperative Pain Management in Patients With Adolescent Idiopathic Scoliosis: Conclusions Based on a Retrospective Study at a Tertiary Pediatric Hospital.
This study evaluated the effectiveness of dexmedetomidine in decreasing opioid use in children with adolescent idiopathic scoliosis following posterior spinal fusion surgery at a pediatric tertiary care hospital over the past 10 years. ⋯ There was no difference in opioid use related to dexmedetomidine on any postoperative day. The only variable showing a significant opioid sparing effect was the use of local anesthetic infusions via elastomeric pumps. Using continuous local anesthetic infusions instead of dexmedetomidine could eliminate the need for ICU admission, require shorter hospital stays, and reduce costs while still providing safe and effective pain control.