Archives françaises de pédiatrie
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We describe the case of a 6 month-old infant suffering from cardiac arrest and successfully resuscitated after epinephrine had been administered through the intraosseous route. During emergency care, vascular access is critical but may be very difficult in young children. Therefore intraosseous infusion appears to be a very efficient alternative for quick administration of drugs and fluids when vascular access is not easily obtained.
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The authors studied the hospital mortality among 0-15 years old children hospitalized in a department of pediatrics in Tunis from 1983 to 1987. A significant decrease in the mortality rate was observed (from 12.21 to 8.23%). ⋯ The maximum of deaths were observed during the Summer-Autumn period and especially in the evenings. The decrease in the mortality rate was correlated with the time when mothers began to be hospitalized with their children.
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A severe poisoning with intravenous phenytoin in a newborn was treated with peritoneal dialysis in spite of its reported poor effectiveness, the drug being 90% protein-bound. During 10 hours, 1.41 mg/hr were eliminated by biotransformation and 1.80 mg/hr were removed with peritoneal dialysis allowing to suppress quickly life threatening cardiac side effects. This efficacy may be explained by an increase in the unbound protein fraction and a diffusion speed through the peritoneum higher than in older patients.