Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2006
Multicenter StudyVariation in pediatric intensive care therapies and outcomes by race, gender, and insurance status.
The differential allocation of medical resources to adult patients according to characteristics such as race, gender, and insurance status raises the serious concern that such issues apply to critically ill children as well. ⋯ Risk-adjusted mortality and resource use for critically ill children did not differ according to race, gender, or insurance status. Policies to expand health insurance to children appear more likely to affect physiologic derangement on admission rather than technical quality of care in the pediatric intensive care unit setting.
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Pediatr Crit Care Me · Jan 2006
Comparative StudyInfrared tympanic thermometry in comparison with other temperature measurement techniques in febrile children.
: To determine whether infrared tympanic thermometry (ITT) measurements more accurately reflect core body temperatures than axillary, forehead, or rectal measurements during fever cycles in children. ⋯ : ITT measurements more accurately reflect core temperatures than any other measurement site during febrile and nonfebrile periods in children. ITT measurements are a reproducible and relatively noninvasive substitute for bladder or rectal measurements in febrile children.
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Cyanide intoxication is an extremely rare event. We report a case of a teenager presenting with unresponsiveness, hemodynamic instability, and profound anion gap metabolic acidosis secondary to elevated lactate levels. It was later confirmed that he was a victim of cyanide poisoning. ⋯ Cyanide poisoning is a rare and potentially fatal event. Prompt recognition of its possibility in a critically ill patient can lead to early intervention with antidote therapy and decrease the extent of morbidity and mortality.
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Pediatr Crit Care Me · Jan 2006
Initial experience with fenoldopam after cardiac surgery in neonates with an insufficient response to conventional diuretics.
Fenoldopam, a selective dopamine-1 receptor agonist, causes systemic vasodilation and increased renal blood flow and tubular sodium excretion. We hypothesized that urine output would improve when fenoldopam was added to conventional diuretic therapy after neonatal cardiopulmonary bypass. ⋯ Fenoldopam may improve urine output in neonates who are failing to achieve an adequate negative fluid balance despite conventional diuretic therapy after cardiac surgery and cardiopulmonary bypass. This study is limited by its retrospective design and the possibility that urine output improved spontaneously during the treatment period. A randomized, placebo-controlled clinical trial will be required to confirm these findings.