Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2010
Case ReportsWithdrawal from multiple sedative agent therapy in an infant: is dexmedetomidine the cause or the cure?
To report withdrawal symptoms experienced by an infant following the prolonged use of dexmedetomidine. ⋯ In patients who fail to achieve adequate sedation with the use of traditional medications, dexmedetomidine is an adequate alternative. However, abrupt discontinuation of dexmedetomidine may result in withdrawal symptoms that may be avoided with a dexmedetomidine taper.
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Pediatr Crit Care Me · Jan 2010
Case ReportsSevere pulmonary hypertension associated with the acute motor sensory axonal neuropathy subtype of Guillain-Barré syndrome.
To evaluate pulmonary hypertension associated with acute motor sensory axonal neuropathy subtype of Guillain-Barré syndrome. Guillain-Barré syndrome consists of a group of autoimmune disorders that generally manifest as symmetric, progressive, ascending paralysis. There are five subtypes of Guillain-Barré syndrome, and autonomic involvement has been described in all subtypes, including cardiovascular, vasomotor, or pseudomotor dysfunction of both the sympathetic and parasympathetic systems. ⋯ It is possible that many other individuals suffering from severe forms of Guillain-Barré syndrome, especially those with significant autonomic dysfunction, may actually have undiagnosed and therefore untreated pulmonary hypertension. Therefore, it is recommended that clinicians caring for critically ill children with Guillain-Barré syndrome have a high index of suspicion for pulmonary hypertension and consider echocardiography if there are clinical signs of this potentially fatal process.
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Pediatr Crit Care Me · Nov 2009
Parental anxiety and medical comprehension within 24 hrs of a child's admission to the pediatric intensive care unit*.
Admission of a child to the pediatric intensive care unit (PICU) can create high-parental anxiety. The authors examined the factors that contribute to parental anxiety and the effect of parental anxiety on comprehension of medical information within 24 hrs of a child's admission to the PICU. The physician's recognition of parental anxiety related to their child's hospitalization was also evaluated. ⋯ Parental anxiety is high following a child's admission to the PICU. Physicians failed to recognize high-parental anxiety in nearly one third of the parents. Despite the high anxiety associated with a child's admission to the PICU, parents seem to understand their children's medical issues within the first 24 hrs.