Acta paediatrica Japonica; Overseas edition
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Experience with pediatric use of intravenous amiodarone is limited. In this study, our experiences with intravenous amiodarone in children with acute life-threatening or chronic tachyarrhythmias are reviewed. ⋯ Intravenous amiodarone is found to be an effective and safe antiarrhythmic agent for children with acute life-threatening and chronic tachyarrhythmias and depressed left ventricular systolic functions.
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Twenty children who were successfully resuscitated after cardiac arrest (CA) were retrospectively studied to examine the hypothesis that children with CA may have a worse neurological outcome in hot weather than in cold weather. Of 7 children with CA in the cold season (atmospheric temperature < 14 degrees C), 4 in the warm season (14-24 degrees C) and 9 in the hot season (> 24 degrees C), 5 (71%), 2 (50%), and 1 (11%), respectively, recovered consciousness (P < 0.05). ⋯ This preliminary study suggests that the neurological outcome of children with CA changes with the seasons, with a worse neurological outcome for CA in hot weather than in cold weather. A prospective study is required to determine whether, in a hot season or area, cooling of pediatric cardiac arrest victims during cardiopulmonary resuscitation on the scene improves the neurological outcome.
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Case Reports
Inhaled nitric oxide followed by extracorporeal membrane oxygenation in resuscitating a newborn with hypoxemia.
In a newborn requiring cardiopulmonary resuscitation because of hypoxemia due to sepsis (oxygenation index > 40), inhalation of nitric oxide (NO) in a concentration of 16 p.p.m. improved oxygenation and restored spontaneous circulation. Cannulation for extracorporeal membrane oxygenation (ECMO) then was performed safely under NO inhalation. ⋯ During follow-up examination at 5 months of age no neurological abnormalities were found. This case shows the usefulness of combining inhaled NO and ECMO.
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A 3-week-old infant developed left shoulder swelling and was found to have septic arthritis and osteomyelitis of the humerus caused by Citrobacter koseri (formerly C. diversus). Citrobacter species are Gram-negative rods that are best known for their propensity to cause neonatal meningitis, ventriculitis and concomitant brain abscess. Non-central nervous system infections are rare. The present case illustrates that neonatal osteomyelitis caused by unusual organisms can present to pediatricians in an inner-city setting, and can respond favorably to surgical and medical management.
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An 11-year-old boy with acute fulminant ulcerative colitis (UC) is presented. He had systemic deterioration with frequent diarrhea and lethargy. ⋯ He was treated with intensive intravenous administration of prednisolone and total parenteral nutrition. He recovered completely without any surgical intervention.