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bicarbonate administration child

Nnenna O Chime, Xun Luo, LeAnn McNamara, Akira Nishisaki, Elizabeth A Hunt
OBJECTIVE: Hyperkalemia is one of the reversible causes of cardiac arrest in children. The Advanced Cardiovascular Life Support guidelines have specific recommendations on the choice and sequence of medications for treatment of life-threatening hyperkalemia. However, the Pediatric Advanced Life Support guidelines have no specific treatment recommendations. The objective of this study was to measure the extent to which opinions diverge among pediatricians on the choice and sequence of medication administration in the management of hyperkalemia during cardiac arrest...
June 2015: Pediatric Critical Care Medicine
Norma Guerra-Hernández, Mario Matos-Martínez, Karen Verónica Ordaz-López, María Dolores Camargo-Muñiz, Mara Medeiros, Laura Escobar-Pérez
INTRODUCTION: Renal tubular acidosis (RTA) is a rare disease characterized by a normal serum anion gap, sustained metabolic acidosis, low concentration of plasma bicarbonate, variable hyperchloremia and hypokalemia and conserved glomerular filtration rate. RTA is developed during the first year of life and produces failure to thrive and anorexia. Primary distal RTA (type 1) is a renal syndrome with a reduced ability to excrete the acid load through the collecting ducts and impairment to concentrate the urine causing polyuria and dehydration...
September 2014: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
Justine Bacchetta, Odile Basmaison, Anne-Laure Leclerc, Aurélia Bertholet-Thomas, Pierre Cochat, Bruno Ranchin
BACKGROUND: The management of tubulopathies after renal transplantation (RTx) may require high doses of sodium and bicarbonate, reducing the quality of life and therapeutic compliance of the patient. Some studies on adult patients have highlighted the benefits of fludrocortisone (fludro) in the treatment of severe tubulopathies. METHODS: This study was a retrospective review of the medical charts of 15 children, aged 12.4 (range 3.6-17.4) years who received fludro after RTx...
October 2014: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Megan G Andrews, Peter N Johnson, Erin M Lammers, Donald L Harrison, Jamie L Miller
BACKGROUND: Acetazolamide is an option for hypochloremic metabolic alkalosis, but there are limited reports in children. OBJECTIVE: To describe the acetazolamide regimen and outcomes in critically ill children with metabolic alkalosis. METHODS: This was a descriptive, retrospective study of patients <18 years of age who received ≥3 doses of acetazolamide for metabolic alkalosis (ie, pH > 7.45 and bicarbonate [HCO3] > 26 mEq/L). Patients receiving other treatments for metabolic alkalosis within 24 hours of acetazolamide were excluded...
September 2013: Annals of Pharmacotherapy
Jason A Levy, Mark Waltzman, Michael C Monuteaux, Richard G Bachur
OBJECTIVES: Children with gastroenteritis often develop dehydration with metabolic acidosis. Serum ketones are frequently elevated in this population. The goal was to determine the relationship between initial serum ketone concentration and both the degree of dehydration and the magnitude of acidosis. METHODS: This was a secondary analysis of a prospective trial of crystalloid administration for rapid rehydration. Children 6 months to 6 years of age with gastroenteritis and dehydration were enrolled...
November 2013: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Charles A Syms, Mary Lou Grantham
OBJECTIVES: We describe a new iontophoresis solution, used in conjunction with a new iontophoresis system for achieving anesthesia of the tympanic membrane before myringotomy and insertion of pressure equalization tubes in an office setting. METHODS: We selected 50 patients (86 ears) who met standard indications for myringotomy only or myringotomy and pressure equalization tube insertion for a single-site consecutive series trial (Institutional Review Board-approved; informed consent and assent) in the authors' clinical practice...
August 2013: Annals of Otology, Rhinology, and Laryngology
Stephen B Freedman, Julie M DeGroot, Patricia C Parkin
BACKGROUND: Emergency Department (ED) revisits are very common in children with gastroenteritis administered intravenous rehydration. STUDY OBJECTIVES: To determine if bicarbonate values are associated with ED revisits in children with gastroenteritis. METHODS: We conducted a secondary analysis of prospectively collected data, which included children >3 months of age with gastroenteritis treated with intravenous rehydration. Regression analysis was employed to determine whether, among discharged children, bicarbonate independently predicts revisits within 7 days (primary outcome) and successful discharge (secondary outcome)...
January 2014: Journal of Emergency Medicine
Melissa J Parker, Christopher S Parshuram
OBJECTIVES: To evaluate the preferences and self-reported practices of pediatric acute care physicians with respect to sodium bicarbonate administration to infants and children in shock or cardiac arrest. DESIGN: National survey study utilizing a self-administered questionnaire. SETTING: Thirteen Canadian pediatric tertiary care centers. SUBJECTS: Canadian pediatric critical care physicians, pediatric emergency physicians, and trainees in these subspecialties...
September 2013: Critical Care Medicine
John E Vajner, Derrick Lung
No abstract text is available yet for this article.
September 2013: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Gaute K Wathle, Erling Tjora, Lars Ersland, Georg Dimcevski, Øyvind O Salvesen, Anders Molven, Pål R Njølstad, Ingfrid S Haldorsen
PURPOSE: To characterize and quantify exocrine pancreatic function by secretin-stimulated magnetic resonance cholangiopancreaticography (s-MRCP) and diffusion-weighted imaging (DWI) in healthy subjects and compare these findings to morphological features, ie, pancreatic volume and secretin-stimulated peak bicarbonate concentration measured in pancreatic juice. MATERIALS AND METHODS: Pancreatic magnetic resonance imaging (MRI) (1.5 T) was performed in 20 healthy volunteers among which 10 underwent gastroscopy with duodenal intubation...
February 2014: Journal of Magnetic Resonance Imaging: JMRI
Muriel Koninckx, Corinne Buysse, Matthijs de Hoog
Recent literature on paediatric status asthmaticus (PSA) confirms an increasing percentage of admissions to paediatric intensive care units. PSA is a medical emergency that can be fatal and needs careful and prompt intervention. The severity of PSA is mainly determined by clinical judgement of signs and symptoms. Peak flow measurements and serial lung function measurements are not reliable in PSA. Validated clinically useful instruments are lacking. The three main factors that are involved in the pathophysiology of PSA, bronchoconstriction, mucus plugging and airway inflammation need to be addressed to optimise treatment...
June 2013: Paediatric Respiratory Reviews
Erin M Buckley, Maryam Y Naim, Jennifer M Lynch, Donna A Goff, Peter J Schwab, Laura K Diaz, Susan C Nicolson, Lisa M Montenegro, Natasha A Lavin, Turgut Durduran, Thomas L Spray, J William Gaynor, Mary E Putt, A G Yodh, Mark A Fogel, Daniel J Licht
BACKGROUND: Sodium bicarbonate (NaHCO3) is a common treatment for metabolic acidemia; however, little definitive information exists regarding its treatment efficacy and cerebral hemodynamic effects. This pilot observational study quantifies relative changes in cerebral blood flow (ΔrCBF) and oxy- and deoxyhemoglobin concentrations (ΔHbO2 and ΔHb) due to bolus administration of NaHCO3 in patients with mild base deficits. METHODS: Infants and children with hypoplastic left heart syndrome (HLHS) were enrolled before cardiac surgery...
May 2013: Pediatric Research
Husein Husein El Ahmed, Guillermo Arturo Cañadas-De la Fuente, Rafael Fernández-Castillo, Emilio González-Jiménez, Jesús Cantero-Hinojosa, Marita Lardón-Fernández
INTRODUCTION: Cutaneous candidiasis is a disease that affects children as well as adults. The presentation may be localized or systemic, and with multiple etiological agents. The most prevalent infecting species in children differs from that of the adult. OBJECTIVE: A case is presented where a congenital cutaneous candidiasis was transmitted to the child during birth. MATERIALS AND METHODS: A full term newborn was exposed to a subclinical vaginal candidiasis infection, and 24 hr after birth, developed congenital cutaneous candidiasis...
June 2012: Biomédica: Revista del Instituto Nacional de Salud
David H Jang, Robert S Hoffman, Lewis S Nelson
BACKGROUND: Flecainide is a class IC antidysrhythmic primarily indicated for ventricular dysrhythmias and supraventricular tachycardia (SVT). Class IC antidysrhythmic overdose has a reported mortality of 22%, and death results from dysrhythmias and cardiovascular collapse. We report a near-fatal flecainide overdose in an 18-day-old treated successfully with sodium bicarbonate. CASE REPORT: An 18-day-old, 2 weeks premature, 4-kg boy developed persistently high heart rates (220-240 beats/min) and electrocardiographic changes consistent with SVT...
April 2013: Journal of Emergency Medicine
Johnny L Luu, Cherry L Wendtland, Matthew F Gross, Farrukh Mirza, Alexander Zouros, Grenith J Zimmerman, Besh Barcega, Shamel A Abd-Allah
OBJECTIVES: The purpose of this study was to describe the administration of 3% saline (3%S) during pediatric critical care transport. METHODS: A retrospective study was performed on pediatric patients who underwent critical transport to Loma Linda University Children's Hospital from January 1, 2003, to June 30, 2007, and were given 3%S. Patients' demographics, admission diagnosis, route and amount of 3%S administration, serum electrolytes, vital signs, radiographic data, and Glasgow Coma Scale scores were collected and analyzed...
December 2011: Pediatric Emergency Care
Nils Dennhardt, Stephan Schoof, Wilhelm A Osthaus, Lars Witt, Harald Bertram, Robert Sümpelmann
OBJECTIVE: This prospective clinical observational study was conducted to investigate the effects of contrast medium on acid-base balance, electrolyte concentrations, and osmolality in children. BACKGROUND: For pediatric cardiac catheterization, high doses of nonionic hyperosmolar contrast medium are widely used. METHODS: Forty pediatric patients (age 0-16 years) undergoing cardiac angiography with more than 3 ml·kg(-1) of nonionic hyperosmolar contrast medium (Iomeprol) were enrolled, and the total amount of the contrast agent given was documented...
November 2011: Paediatric Anaesthesia
Adnan T Bhutta, Michael L Schmitz, Christopher Swearingen, Laura P James, Wendy L Wardbegnoche, Diana M Lindquist, Charles M Glasier, Volkan Tuzcu, Parthak Prodhan, Umesh Dyamenahalli, Michiaki Imamura, Robert D B Jaquiss, Kanwaljeet J S Anand
OBJECTIVE: Infants are potentially more susceptible to cell death mediated via glutamate excitotoxicity attributed to cardiopulmonary bypass. We hypothesized that ketamine, via N-methyl D-aspartate receptor blockade and anti-inflammatory effects, would reduce central nervous system injury during cardiopulmonary bypass. METHODS: We randomized 24 infants, without chromosomal abnormalities, to receive ketamine (2 mg/kg, n = 13) or placebo (saline, n = 11) before cardiopulmonary bypass for repair of ventricular septal defects...
May 2012: Pediatric Critical Care Medicine
Miguel Fonte, Ignacio Oulego-Erroz, Antonio Rodríguez-Núñez, Jose A Iglesias-Vázquez, Luis Sánchez-Santos
INTRODUCTION: Pediatric out-of-hospital cardiorespiratory arrest (CRA) is a rare event but has a high mortality and morbidity among survivors. In 2005, an international consensus on science and treatment recommendations has been released, with the aim of improving the assistance of patients who had and, eventually, increasing survival without neurologic sequelae. Our objective was to assess the impact of the 2005 guidelines on the initial prehospital assistance of children with out-of-hospital CRA in a community with scattered population...
August 2011: Pediatric Emergency Care
Ali Bulbul, Fusun Okan, Lida Bulbul, Asiye Nuhoglu
OBJECTIVE: To study the efficacy of early high doses parenteral nutrition (PN) versus early low dose with progressive increments PN regimens, we performed a prospective randomized study in very low birth-weight infants. STUDY DESIGN: Forty-one appropriate gestational age preterm infants with birth weights ranging from 750-1500 g were randomly assigned into two groups. In Group 1, infants started on 3.0 g/kg/day amino acids (AA) and 3 g/kg/day of 20% lipid; in Group 2, AA and lipid were started on 1 g/kg/day, and advanced over 3 days to a maximum 3 g/kg/day...
June 2012: Journal of Maternal-fetal & Neonatal Medicine
Sheng-Chun Yang, Chao-Long Chen, Chih-Hsien Wang, Chia-Jung Huang, Kwok-Wai Cheng, Shao-Chun Wu, Bruno Jawan
OBJECTIVES: Liver retransplantation (Re-LT) is the effective therapy for irreversible liver graft failure after primary liver transplantation (LT). The challenges faced by the operative team in the Re-LT setting have been seldom elucidated. Our aim is to analyze the differences in fluid management in primary LT and Re-LT during the surgical procedure. METHODS: The anesthesia charts of 16 patients who underwent both primary LT and Re-LT at our center in the space from October 1995 to May 2009 were analyzed...
June 2011: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
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