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Metabolic alkalosis pediatric

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https://www.readbyqxmd.com/read/27748700/acetazolamide-therapy-for-metabolic-alkalosis-in-pediatric-intensive-care-patients
#1
Carolina López, Andrés José Alcaraz, Blanca Toledo, Lucía Cortejoso, Maite Augusta Gil-Ruiz
OBJECTIVE: Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients. DESIGN: Retrospective, observational study. SETTING: A tertiary care children's hospital PICU. PATIENTS: Children receiving at least a 2-day course of enteral acetazolamide...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27325428/liddle-syndrome-in-a-turkish-family-with-heterogeneous-phenotypes
#2
Bahar Büyükkaragöz, Aysun Caltik Yilmaz, Deniz Karcaaltincaba, Osman Ozdemir, Michael Ludwig
Liddle syndrome (LS) is a familial disease characterized by early onset hypertension (HT). Although regarded as rare, its incidence may be greater than expected because the classical findings of hypokalemic metabolic alkalosis with suppressed renin and aldosterone levels are not consistently present. Herein, we present the case of an adolescent boy and maternal relatives who were followed up with misdiagnosis of essential HT for a long duration. Clinical diagnosis of LS was confirmed on genetic analysis. Despite carrying the same mutation, the index patient and the family members manifested heterogeneous phenotypes of the disease including age at presentation, degree of HT, presence of hypokalemia and renal/cardiac complications...
August 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/26123148/ultrasound-guided-paravertebral-block-for-pyloromyotomy-in-3-neonates-with-congenital-hypertrophic-pyloric-stenosis
#3
Javier Mata-Gómez, Rosana Guerrero-Domínguez, Marta García-Santigosa, Antonio Ontanilla
BACKGROUND AND OBJECTIVES: Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis...
July 2015: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/25960362/-ultrasound-guided-paravertebral-block-for-pyloromyotomy-in-3-neonates-with-congenital-hypertrophic-pyloric-stenosis
#4
Javier Mata-Gómez, Rosana Guerrero-Domínguez, Marta García-Santigosa, Antonio Ontanilla
BACKGROUND AND OBJECTIVES: Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis...
July 2015: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/25647140/acetazolamide-therapy-for-metabolic-alkalosis-in-critically-ill-pediatric-patients
#5
Amir Bar, Jeff Cies, Kathleen Stapleton, Danna Tauber, Arun Chopra, Paul M Shore
OBJECTIVE: Despite a paucity of supporting literature, acetazolamide is commonly used in critically ill children with metabolic alkalosis (elevated plasma bicarbonate [pHco-3] and pH). The objective of this study was to assess the change in 18 hours after initiation of acetazolamide therapy. DESIGN: Retrospective study. SETTING: PICU of an urban, tertiary-care children's hospital. PATIENTS: Mechanically ventilated children (≤ 17 yr) with metabolic alkalosis (pHco-3 ≥ 35 mmol/L)...
February 2015: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/25563826/furosemide-versus-ethacrynic-acid-in-pediatric-patients-undergoing-cardiac-surgery-a-randomized-controlled-trial
#6
RANDOMIZED CONTROLLED TRIAL
Zaccaria Ricci, Roberta Haiberger, Chiara Pezzella, Cristiana Garisto, Isabella Favia, Paola Cogo
INTRODUCTION: Clinical effects of furosemide (F) and ethacrynic acid (EA) continuous infusion on urine output (UO), fluid balance, and renal, cardiac, respiratory, and metabolic function were compared in infants undergoing surgery for congenital heart diseases. METHODS: A prospective randomized double-blinded study was conducted. Patients received 0.2 mg/kg/h (up to 0.8 mg/kg/h) of either F or EA. RESULTS: In total, 38 patients were enrolled in the F group, and 36, in the EA group...
2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25379736/comparison-of-arginine-hydrochloride-and-acetazolamide-for-the-correction-of-metabolic-alkalosis-in-pediatric-patients
#7
Daniel E Heble, Alexandra Oschman, Tracy L Sandritter
Metabolic alkalosis is a common acid-base disturbance occurring in critically ill pediatric patients. Acetazolamide and arginine hydrochloride are pharmacologic agents used at our institution for patients refractory to first-line therapy or those unable to tolerate fluid replacement. The objective of this retrospective review was to determine if a course of arginine hydrochloride or acetazolamide was more effective at correcting metabolic alkalosis within a 24-hour period. Patients included received a course of acetazolamide or arginine hydrochloride for metabolic alkalosis with a repeat metabolic panel 18-30 hours after treatment initiation...
November 2016: American Journal of Therapeutics
https://www.readbyqxmd.com/read/24782692/ethacrynic-acid-continuous-infusions-in-critically-ill-pediatric-patients
#8
Jamie L Miller, Jared Schaefer, Matthew Tam, Donald L Harrison, Peter N Johnson
OBJECTIVES: The purpose of this study was to describe dosage regimens and treatment outcomes in critically ill children receiving ethacrynic acid continuous infusions (CI). METHODS: This retrospective cross-sectional study evaluated patients less than 18 years of age who received ethacrynic acid CI with a duration exceeding 12 hours, from January 1, 2007, through January 31, 2012. The primary objective was to determine the mean/median doses of ethacrynic acid CI...
January 2014: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/24623294/clinical-presentation-of-cystic-fibrosis-at-the-time-of-diagnosis-a-multicenter-study-in-a-region-without-newborn-screening
#9
MULTICENTER STUDY
Fatemeh Farahmand, Manijeh Khalili, Leila Shahbaznejad, Armin Hirbod-Mobarakeh, Mehri Najafi Sani, Ahmad Khodadad, Farzaneh Motamed, Nima Rezaei
BACKGROUND/AIMS: Cystic fibrosis is the most common inherited lethal disease, which could be frequently identified late in regions without newborn screening. There are dramatically better outcomes in the early diagnosis of cystic fibrosis patients. This study aimed to evaluate the spectrum of manifestations of cystic fibrosis at first admission leading to diagnosis. MATERIALS AND METHODS: This study was performed in a multi-referral pediatrics center in Iran. Data of patients with cystic fibrosis at the time of diagnosis were recorded based on a checklist denoting demographic characteristics, clinical and laboratory features...
2013: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/24519774/-congenital-chloride-diarrhea-mimicking-meconium-ileus-in-newborn
#10
Grażyna Krzemień, Agnieszka Szmigielska, Katarzyna Jankowska, Maria Roszkowska-Blaim
Congenital chloride diarrhoea is a rare autosomal recessive disease and the diagnosis is frequently delayed. The disease is most common in Saudi Arabia and Kuwait 1:3200-13 000 births, Finland - 1:30 000-40 000, and in Poland - 1:200 000. Congenital chloride diarrhoea begins in fetal life. The main clinical sign is watery diarrhea that in utero leads to dilated bowel loops, polyhydramnios and often premature birth. Newborns have distended abdomens, absence of meconium, dilated bowel loops in ultrasonography and watery diarrhea which can sometimes be mistaken for urine...
October 2013: Medycyna Wieku Rozwojowego
https://www.readbyqxmd.com/read/24389778/diabetic-ketoalkalosis-in-children-and-adults
#11
Emily A Huggins, Shawn A Chillag, Ali A Rizvi, Robert R Moran, Martin W Durkin
OBJECTIVES: Diabetic ketoacidosis (DKA) with metabolic alkalosis (diabetic ketoalkalosis [DKALK]) in adults has been described in the literature, but not in the pediatric population. The discordance in the change in the anion gap (AG) and the bicarbonate is depicted by an elevated delta ratio (DR; rise in AG/drop in bicarbonate), which is normally approximately 1. The primary aim of this study was to determine whether DKALK occurs in the pediatric population, as has been seen previously in the adult population...
January 2014: Southern Medical Journal
https://www.readbyqxmd.com/read/23528507/electrolyte-profile-of-pediatric-patients-with-hypertrophic-pyloric-stenosis
#12
Godfrey Jay Tutay, Geoffrey Capraro, Blake Spirko, Jane Garb, Howard Smithline
OBJECTIVES: Recent investigations have demonstrated that the classic hypochloremic, hypokalemic, metabolic alkalosis of hypertrophic pyloric stenosis (HPS) is not a common finding.Some have suggested a trend over time, but none has investigated factors contributing to laboratory derangement, such as duration of vomiting or patient age at presentation. We sought to determine the proportion of patients with HPS with normal and abnormal laboratory findings as a function of year of presentation, duration of vomiting, and patient age...
April 2013: Pediatric Emergency Care
https://www.readbyqxmd.com/read/23457317/conn-syndrome-and-crohn-disease-in-a-pediatric-case-an-interesting-parallel
#13
Manuel A Rodriguez, Fuad Alkhoury, Leopoldo Malvezzi, Alejandro Diaz
Conn syndrome is characterized by surreptitious secretion of aldosterone in which patients are found to have hypertension, hypokalemia, and metabolic alkalosis. Although rare, the most common presentation in the pediatric population is bilateral hyperplasia of the adrenal glands as opposed to an adenoma. Crohn disease is part of the spectrum of inflammatory bowel disease, which manifests in children as flare-ups of bloody diarrhea and abdominal pain. The association of concurrent Conn syndrome and Crohn disease has been previously presented in two cases in adults...
2013: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/23438777/pediatric-ecmo-outcomes-comparison-of-centrifugal-versus-roller-blood-pumps-using-propensity-score-matching
#14
COMPARATIVE STUDY
Cindy S Barrett, James J Jaggers, E Francis Cook, Dionne A Graham, Vasmi V Yarlagadda, Sarah A Teele, Christopher S Almond, Susan L Bratton, John D Seeger, Heidi J Dalton, Peter T Rycus, Peter C Laussen, Ravi R Thiagarajan
Centrifugal blood pumps are being increasingly utilized in children supported with extracorporeal membrane oxygenation (ECMO). Our aim was to determine if survival and ECMO-related morbidities in children supported with venoarterial (VA) ECMO differed by blood pump type.Children aged less than 18 years who underwent VA ECMO support from 2007 to 2009 and reported to the Extracorporeal Life Support Organization registry were propensity score matched (Greedy 1:1 matching) using pre-ECMO characteristics.A total of 2,656 (centrifugal = 2,231, roller = 425) patients were identified and 548 patients (274 per pump type) were included in the propensity score-matched cohort...
March 2013: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/23118664/injectable-ammonium-chloride-used-enterally-for-the-treatment-of-persistent-metabolic-alkalosis-in-three-pediatric-patients
#15
Jennie T Mathew, Laura L Bio
Enteral administration of injectable ammonium chloride may offer an effective method for the treatment of persistent metabolic alkalosis, without the adverse effects associated with the intravenous route. This case series describes 3 pediatric patients who received ammonium chloride enterally for the treatment of persistent metabolic alkalosis. The patients were a 2-month-old female infant, a 6-week-old male infant, and a 3-year-old male toddler. Four to 18 doses of ammonium chloride were administered enterally (range, 3-144 mEq/dose)...
January 2012: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/23021957/-pediatric-nutrition-severe-deficiency-complications-by-using-vegetable-beverages-four-cases-report
#16
Diane Fourreau, Noël Peretti, Baptiste Hengy, Yves Gillet, Sonia Courtil-Teyssedre, Laure Hess, Irène Loras-Duclaux, Nicolas Caron, Capucine Didier, Fleur Cour-Andlauer, Sophie Heissat, Alain Lachaux, Etienne Javouhey
INTRODUCTION: The use of vegetable beverages improperly called « vegetable milk » is promoted by food faddism to replace dairy products, even in infant diet whereas it is totally inadequate. CASE REPORTS: Case 1: a 9 month-old infant fed by a rice beverage for 2 months presented hypoalbuminemia (7 g/L) with kwashiorkor syndrome complicated by severe sepsis. Case 2: a 14 month-old infant fed by a rice beverage for 2 months had iron and vitamin B12 deficiency with deep anemia (Hb 35 g/L) and tissue hypoxia (hyperlactacidemia)...
February 2013: La Presse Médicale
https://www.readbyqxmd.com/read/22856410/-bartter-syndrome-a-new-therapeutic-approach
#17
Marta Mendonça, Adriana Pinheiro, Isabel Castro
The Bartter syndrome is a rare hereditary salt-wasting tubulopathy, characterized by metabolic alkalosis, hypokalemia, hyperreninemia and hyperaldosteronemia of varying severity. Indomethacin and high doses of oral potassium have been until now the therapeutic strategies used, with high risk of gastrointestinal injury. Since April 2009, aliskiren--renin inhibitor--has been used in individual cases of Bartter syndrome in adults, by ignoring its use in pediatrics. The authors present the case of an eight year old child with Bartter syndrome, treated with oral potassium chloride and oral indomethacin, whom has been diagnosed a giant gastric ulcer...
December 2011: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/22366877/hyponatremic-hypertensive-syndrome-in-pediatric-patients-is-it-really-so-rare
#18
Yael Kovalski, Roxana Cleper, Irit Krause, Benjamin Dekel, Alexander Belenky, Miriam Davidovits
BACKGROUND: Hyponatremic hypertensive syndrome (HHS) is characterized by unilateral renal artery stenosis with secondary hypertension and glomerular and tubular dysfunction due to hyperfiltration and activation of the renin-angiotensin system (RAS). CASE-DIAGNOSIS/TREATMENT: We describe four children with HHS. All presented with polyuria and polydipsia, electrolyte disturbances, metabolic alkalosis, variable tubular dysfunction, and nephrotic range proteinuria along with hypertension...
June 2012: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/21926883/ornithine-transcarbamylase-deficiency-presenting-as-recurrent-abdominal-pain-in-childhood
#19
Aizeddin A Mhanni, Chitra Prasad, Cheryl Rockman-Greenberg
Recurrent abdominal pain remains one of the most common symptoms in pediatrics. We present the case of a 3-year-old girl who had recurrent episodes of abdominal pain requiring more than 13 visits to the emergency department. A diagnosis of ornithine transcarbamylase deficiency was eventually made. Urea cycle disorders often present beyond the neonatal period with frequent vomiting episodes; however, recurrent abdominal pain as a presenting symptom is unusual. Unnecessary invasive investigations of recurrent abdominal pain in childhood can be avoided by considering inborn errors of metabolism earlier in the differential diagnosis...
September 2011: Pediatric Emergency Care
https://www.readbyqxmd.com/read/21750641/cystinosis-presenting-with-findings-of-bartter-syndrome
#20
Behzat Özkan, Atilla Çayır, Celalettin Koşan, Handan Alp
A five-year-old boy was referred to our pediatric clinic for evaluation of failure to thrive, headache, intermittent high fever, restlessness, polyuria, and polydipsia. His weight and height measurements were under the 3rd percentile. Clinical findings consisted of frontal bossing, carious teeth, O-bain deformity of the lower extremities, and moderate dehydration. The presence of metabolic alkalosis, hypokalemia, hypochloremia, and high renin and aldosterone levels were suggestive of Bartter syndrome and a treatment regimen for Bartter syndrome was started...
2011: Journal of Clinical Research in Pediatric Endocrinology
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