Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2008
Randomized Controlled TrialThe umbilical arterial catheter: a formula for improved positioning in the very low birth weight infant.
: An umbilical arterial catheter is often used to monitor blood pressure and take frequent blood samples in the very low birth weight newborn infant requiring neonatal intensive care. Incorrect placement of the umbilical arterial catheter increases catheter complications, and adjustment of catheter position after radiograph increases infant handling and infection risk. Current methods overestimate insertion length in very low birth weight babies. We suggest a new formula for calculating insertion length that is more appropriate for today's neonatal intensive care population. The Umbilical Arterial Catheter Calculation Study, Australian Perinatal Trials Register PT0398, was set up to investigate this technical change. Our hypothesis was that the new formula would improve the siting of umbilical arterial catheters in very low birth weight infants. ⋯ : The use of the new formula results in better overall placement and in significantly less overinsertion of umbilical artery catheters in very low birth weight infants.
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Pediatr Crit Care Me · Sep 2008
Elevation of brain natriuretic peptide levels in children with septic shock.
1) To compare brain natriuretic peptide levels in pediatric patients with septic shock with both children admitted to the pediatric intensive care unit without infection and with healthy subjects; and 2) to evaluate the correlation between brain natriuretic peptide with severity of illness and with myocardial dysfunction in children with septic shock. ⋯ Brain natriuretic peptide measured early after admission is increased in children with septic shock, especially in those with cold shock. In addition, the level at 12 hrs correlates with both severity of illness and myocardial dysfunction. Brain natriuretic peptide may be useful in assessing myocardial dysfunction from septic shock, particularly in identifying children with cold shock. Further studies are warranted to determine whether this measurement will be helpful in guiding therapy in pediatric septic shock.
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To review the physiology and the published literature on the role of vasopressin in shock in children. ⋯ Vasopressin offers promise in shock and cardiac arrest in children. However, in view of the limited experience with vasopressin, it should be used with caution. Results of a double-blind, randomized controlled trial in children with vasodilatory shock will be available soon.