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fluid therapy pediatric

Anna E van Beek, Angela Kamp, Simone Kruithof, Ed J Nieuwenhuys, Diana Wouters, Ilse Jongerius, Theo Rispens, Taco W Kuijpers, Kyra A Gelderman
Complement is activated as part of the innate immune defense against invading pathogens. Also, it helps to remove apoptotic debris and immune complexes from the circulation. Impaired complement function due to aberrant plasma levels of complement proteins may be indicative for complement-mediated diseases or can be involved in susceptibility for infections. To determine whether plasma levels are abnormal, reference intervals (RIs) are used from adult healthy donors. Since many complement-mediated diseases have an onset during childhood, it is important to know whether these RIs can be extrapolated to children...
2018: Frontiers in Immunology
Tareq Al-Ayed, Naveed Ur Rahman, Abdullah Alturki, Fahad Aljofan
BACKGROUND: Continuous renal replacement therapy (CRRT) has become the preferred mode of dialysis to support critically ill children with acute kidney injury. However, there are limited pediatric data on CRRT use, especially in our region. OBJECTIVE: Determine the outcome of CRRT among critically ill children. DESIGN: Retrospective cohort study. SETTING: Pediatric intensive care unit. PATIENTS AND METHODS: The study included critically ill children 1-14 years of age who underwent CRRT from July 2009 to June 2015...
July 2018: Annals of Saudi Medicine
Shunpei Okochi, Eva W Cheung, Sunjay Barton, Ariela Zenilman, Aqsa Shakoor, Cherease Street, Svetlana Streltsova, Christine Chan, Michael P Brewer, William Middlesworth
OBJECTIVES: Hemolysis is a known complication of pediatric extracorporeal membrane oxygenation associated with renal failure and mortality. We sought to identify predictors of hemolysis in pediatric extracorporeal membrane oxygenation patients and determine its influence on outcomes. DESIGN: Retrospective, single-center study. SETTING: Urban, quaternary care center pediatric and neonatal ICU. PATIENTS: Ninety-six patients requiring extracorporeal membrane oxygenation...
July 27, 2018: Pediatric Critical Care Medicine
Katherine Harer, Jennifer Mann, Nicole Muhlbauer, Jennifer Welch, Brian Alverson
We present the case of a 16-year-old girl who presented with severe refractory orthostatic hypotension secondary to pandysautonomia. Initially, she was treated for Guillain-Barré syndrome given clinical symptoms and increased protein on cerebrospinal fluid, but the severity of symptoms and lack of response to intravenous immunoglobulin prompted further evaluation for an autoimmune etiology. She was ultimately diagnosed with paraneoplastic neuropathy secondary to Hodgkin lymphoma. Paraneoplastic neurologic phenomena are rare, occurring in just 0...
July 24, 2018: Pediatric Emergency Care
Francesco Pichi
PURPOSE: To report a case of pediatric vascularized sarcoid choroidal granuloma complicated by placoid-like inflammation. METHODS: Case report. RESULTS: A 10-year-old girl presented with blurry vision in her right eye and a yellowish macular lesion that had been diagnosed as fibrotic choroidal neovascular membrane and observed for several months. On referral to our clinic, optical coherence tomography revealed a homogeneous hyperreflective lesion obliterating the choroidal vasculature and protruding under the retina with associated subretinal and intraretinal fluid...
July 24, 2018: Retinal Cases & Brief Reports
Hiroshi Hataya
BACKGROUND: Recent statistics have revealed that the number of patients with preemptive kidney transplant (KTx) has increased to 21.9% between 2006 and 2011. However, factors like body height, lack of kidney source, and severe complications render some patients ineligible for KTx. Peritoneal dialysis (PD) acts as the bridging therapy to KTx, especially for infants and young children. Because the period of PD treatment is relatively longer in Japan due to the lack of kidney donors, management of PD is imperative for the success of the treatment...
2018: Contributions to Nephrology
Adil R Dingankar, Dominic A Cave, Vijay Anand, V Ben Sivarajan, Susan Nahirniak, Cathy Sheppard, Jan Hanot, Gonzalo Garcia Guerra
OBJECTIVES: To determine the clinical benefit of using colloids versus crystalloids for volume resuscitation in children admitted after cardiac surgery. DESIGN: Retrospective pre-/postintervention cohort study. SETTING: Stollery Children's Hospital tertiary care pediatric cardiac ICU. PATIENTS: Children admitted to the pediatric cardiac ICU after cardiac surgery. INTERVENTIONS: Fluid resuscitation policy change in which crystalloids replaced albumin 5% as the primary fluid strategy for resuscitation after cardiac surgery...
July 17, 2018: Pediatric Critical Care Medicine
Gabriella S Lamb, Coralee Del Valle Mojica, Nivedita Srinivas, Jeffrey Starke
A 4-year-old former 24-week gestation male and an 18-month-old former 26-week gestation female, both with history of intraventricular hemorrhage resulting in hydrocephalus, presented with Mycobacterium abscessus ventricular shunt infections affecting both the shunt track and the ventricular fluid. Both children required prolonged combination antimycobacterial therapy; the 4 year old required more than two months of triple intravenous antibiotics and intraventricular amikacin to sterilize the cerebrospinal fluid...
July 11, 2018: Pediatric Infectious Disease Journal
Felice D'Arco, Sinead Culleton, Laurens J L De Cocker, Kshitij Mankad, Jorge Davila, Benita Tamrazi
Pediatric brain tumors differ from those in adults by location, phenotype and genotype. In addition, they show dissimilar imaging characteristics before and after treatment. While adult brain tumor treatment effects are primarily assessed on MRI by measuring the contrast-enhancing components in addition to abnormalities on T2-weighted and fluid-attenuated inversion recovery images, these methods cannot be simply extrapolated to pediatric central nervous system tumors. A number of researchers have attempted to solve the problem of tumor assessment during treatment in pediatric neuro-oncology; specifically, the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group was recently established to deal with the distinct challenges in evaluating treatment-related changes on imaging, but no established criteria are available...
July 6, 2018: Pediatric Radiology
Christina S Manice, Paul J Planet, Herbert S Chase, Christine T Lauren
OBJECTIVES: To assess the management and outcomes of vesicles and pustules in afebrile neonates presenting to the pediatric emergency department. METHODS: Using International Classification of Diseases, Ninth Revision, codes, we identified patients 0-60 days old presenting to our pediatric emergency department from 2008 to 2015 with a possible diagnosis of pustules or vesicles. We then used natural language processing followed by manual chart review to identify afebrile neonates with pustules or vesicles...
July 4, 2018: Pediatric Dermatology
Hannah Kinoshita, Leon Grant, Konstantine Xoinis, Prashant J Purohit
Central pontine myelinolysis (CPM) is rarely reported in pediatric patients with diabetic ketoacidosis (DKA). We report this case of a 16-year-old female with new onset diabetes presenting with DKA, who received aggressive fluid resuscitation and sodium bicarbonate in the emergency department. Later she developed altered mental status concerning for cerebral edema and received hyperosmolar therapy with only transient improvement. Soon she became apneic requiring emergent endotracheal intubation. MRI brain showed cerebral edema, CPM, and subdural hemorrhage...
2018: Case Reports in Critical Care
Olga Maliszewska, Alina Plenis, Ilona Olędzka, Piotr Kowalski, Natalia Miękus, Ewa Bień, Małgorzata Anna Krawczyk, Elżbieta Adamkiewicz-Drożynska, Tomasz Bączek
A simple, rapid, reliable and sensitive method based on liquid chromatography with fluorescence detection (LC-FL) for the quantification of doxorubicin (DOX) in human plasma and urine samples was developed. The assay was carried out after the solid-phase extraction procedure (SPE) with hydrophilic-lipophilic balance (HLB) cartridges, and with daunorubicin hydrochloride (DAU) used as the internal standard. Chromatographic separation was performed on a Discovery HS C18 column in isocratic elution mode, and the detection of the analytes set at excitation and emission wavelengths of 487 and 555 nm, respectively...
September 5, 2018: Journal of Pharmaceutical and Biomedical Analysis
Bongjin Lee, Soo Jung Kim, June Dong Park, Jiun Park, Ae Hee Jung, Sun Hoi Jung, Yu Hyeon Choi, Hee Gyung Kang, Il Soo Ha, Hae Il Cheong
Vancomycin is known to be unintentionally eliminated by continuous renal replacement therapy, and the protein bound fraction of vancomycin is also known to be different in adults and children. However, there are only a few studies investigating the relationship between the dose of continuous venovenous hemodiafiltration (CVVHDF) parameters and serum concentration of vancomycin in pediatric patients. The aim of this study was to determine clinical and demographic parameters that significantly affect serum vancomycin concentrations...
2018: PloS One
Irene Tadeo, Esther Gamero-Sandemetrio, Ana P Berbegall, Marta Gironella, Félix Ritort, Adela Cañete, Gloria Bueno, Samuel Navarro, Rosa Noguera
Neuroblastoma is the most common extra-cranial solid pediatric cancer and causes approximately 15% of all childhood deaths from cancer. Although lymphatic vasculature is a prerequisite for the maintenance of tissue fluid balance and immunity in the body, little is known about the relationship between lymphatic vascularization and prognosis in neuroblastoma. We used our previously-published custom-designed tool to close open-outline vessels and measure the density, size and shape of all lymphatic vessels and microvascular segments in 332 primary neuroblastoma contained in tissue microarrays...
May 25, 2018: Oncotarget
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
Natacha D Stolowy, Benjamin P Donnadieu, Alban Cm Comet, Sébastien Nadeau, Marie A-S Beylerian, Danièle Denis, Frédéric J Matonti
Background/ purpose: Diffuse subretinal fibrosis and uveitis syndrome is an inflammatory disease rarely reported. The purpose of this article is to describe a rare case of diffuse subretinal fibrosis syndrome in an 8-year-old child. METHODS AND RESULTS: The patient initially presented with a loss of vision in his right eye, with a visual acuity of 20/200. The visual acuity of the left eye was normal. Clinical examination showed bilateral anterior and posterior inflammation while the fundus revealed on the right eye an inter maculopapillar fibrosed lesion with a discrete retinal hemorrhage and a similar but smaller lesion on the left eye...
May 1, 2018: European Journal of Ophthalmology
G Pestel, K Fukui, M Higashi, I Schmidtmann, C Werner
An ideal non-invasive monitoring system should provide accurate and reproducible measurements of clinically relevant variables that enables clinicians to guide therapy accordingly. The monitor should be rapid, easy to use, readily available at the bedside, operator-independent, cost-effective and should have a minimal risk and side effect profile for patients. An example is the introduction of pulse oximetry, which has become established for non-invasive monitoring of oxygenation worldwide. A corresponding non-invasive monitoring of hemodynamics and perfusion could optimize the anesthesiological treatment to the needs in individual cases...
June 2018: Der Anaesthesist
Y P Zhou, J Y Shi, F Wang, Y Cui, T T Xu, C X Wang, Y C Zhang
Objective: To explore the effectiveness and safety of continuous renal replacement therapy (CRRT) combined with extracorporeal membrane oxygenation (ECMO) on rescuing pediatric patients with cardiopulmonary failure. Methods: The medical records of patients treated with ECMO admitted to pediatric intensive care unit (PICU) in Shanghai Children's Hospital from December 2015 to November 2017 were retrospectively extracted. There were 14 patients treated with ECMO combined with CRRT (ECMO+ CRRT group) due to acute kidney injury (AKI) or fluid overload, while 11 cases treated with ECMO only...
May 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Sidharth K Sethi, Veena Raghunathan, Shilpi Shah, Maninder Dhaliwal, Pranaw Jha, Maneesh Kumar, Sravanthi Paluri, Shyam Bansal, Maroun J Mhanna, Rupesh Raina
Objectives: We investigated the association of fluid overload and oxygenation in critically sick children, and their correlation with various outcomes (duration of ventilation, ICU stay, and mortality). We also assessed whether renal angina index (RAI) at admission can predict mortality or acute kidney injury (AKI) on day 3 after admission. Design and setting: Prospective study, pediatric intensive care in a tertiary hospital. Duration: June 2013-June 2014. Patients: Patients were included if they needed invasive mechanical ventilation for >24 h and had an indwelling arterial catheter...
2018: Frontiers in Pediatrics
Soledad González, Mirta Carbonaro, Ana G Fedullo, María I Sormani, María Del C Ceinos, Roberto González, María T Rosanova
INTRODUCTION: Infections are the most common complications of ventricular cerebrospinal fluid shunts. The objective of this study was to describe the clinical, microbiological, and evolutionary characteristics of children with ventricular cerebrospinal fluid shunt-associated infections and analyze the risk factors for mortality. POPULATION AND METHODS: Descriptive, retrospective study carried out at Hospital "Prof. Dr. Juan P. Garrahan" in the Autonomous City of Buenos Aires...
June 1, 2018: Archivos Argentinos de Pediatría
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