Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2008
Editorial CommentOdds ratios, and odd musings, about neonatal septic shock.
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Pediatr Crit Care Me · Mar 2008
Randomized Controlled TrialCombination of recombinant human growth hormone and propranolol decreases hypermetabolism and inflammation in severely burned children.
Recombinant human growth hormone (rhGH) is a salutary modulator of posttraumatic metabolic responses. However, rhGH administration is associated with deleterious side effects, such as hyperglycemia, increased free fatty acids, and triglycerides, which limit its use. Administration of beta-blocker attenuates cardiac work and resting energy expenditure after severe thermal injury and improves fat metabolism and insulin sensitivity. Therefore, the combination of rhGH plus propranolol appears ideal. The aim of the present study was to determine whether rhGH plus propranolol improves hypermetabolism and the inflammatory and acute phase response after severe burn without causing adverse side effects. ⋯ rhGH in combination with propranolol attenuates hypermetabolism and inflammation without the adverse side effects found with rhGH therapy alone.
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Pediatr Crit Care Me · Mar 2008
ReviewTherapeutic applications and uses of inhalational anesthesia in the pediatric intensive care unit.
To review the physical properties, end-organ effects, therapeutic applications, and delivery techniques of inhalational anesthetic agents in the pediatric intensive care unit. ⋯ The literature contains reports of the therapeutic use of the potent inhalational anesthetic agents in the pediatric intensive care unit. Potential applications include sedation during mechanical ventilation as well as therapeutic use for the treatment of status asthmaticus and epilepticus.
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Pediatr Crit Care Me · Mar 2008
Incidence of hypo- and hypercarbia in severe traumatic brain injury before and after 2003 pediatric guidelines.
To examine the incidence of severe hypocarbia (PaCO2 <30 mm Hg) in patients with severe pediatric traumatic brain injury before and after publication of the 2003 pediatric guidelines (PG). ⋯ Although PaCO2 sampling was more frequent during the post-PG period and severe hypocarbia decreased during successive study years, the incidence of severe hypocarbia remained high during the first 48 hrs after hospital admission during the post-PG period. Time to PaCO2 sampling was longer in young children and associated with more severe hypocarbia. The presence of severe hypocarbia predicted mortality.
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Pediatr Crit Care Me · Mar 2008
Glucose control, organ failure, and mortality in pediatric intensive care.
In ventilated children, to determine the prevalence of hyperglycemia, establish whether it is associated with organ failure, and document glycemic control practices in Australasian pediatric intensive care units (PICUs). ⋯ Hyperglycemia is common in PICUs, occurs early, and is independently associated with organ failure and death. However, early hyperglycemia is not associated with later or worsening organ failure. Australasian PICUs seldom use insulin.