Jornal de pediatria
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Jornal de pediatria · Jul 2011
ReviewDevelopmental outcomes and quality of life in children born preterm at preschool- and school-age.
To review literature published in the last 5 years on the effects of premature birth on the development and quality of life of preschool- and school-age children. ⋯ Children born extremely premature (≤ 30 weeks' gestational age) are vulnerable to developmental and quality of life problems.
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Jornal de pediatria · Mar 2008
ReviewEmergence agitation in pediatric anesthesia: current features.
Postoperative agitation in children is a well-documented clinical phenomenon with incidence ranging from 10% to 67%. There is no definitive explanation for this agitation. Possible causes include rapid awakening in unfamiliar settings, pain (wounds, sore throat, bladder distension, etc.), stress during induction, hypoxemia, airway obstruction, noisy environment, anesthesia duration, child's personality, premedication and type of anesthesia. The purpose of this paper is to discuss the possible causes of postoperative agitation in children, providing a foundation for better methods of identifying and preventing this problem. ⋯ No single factor can identified as the cause of postoperative agitation, which should therefore be considered a syndrome made up of biological, pharmacological, psychological and social components, and which anesthesiologists and pediatric intensive care specialists should be prepared to identify, prevent and intervene appropriately as necessary.
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Jornal de pediatria · Nov 2007
ReviewHemodynamic and metabolic effects of vasopressin infusion in children with shock.
Vasopressin is a neuropeptide hormone which has been used clinically for more than 50 years and plays a major role in circulatory homeostasis and in the regulation of serum osmolality. Recent work has emphasized its role in the treatment of septic shock. This paper reviews the physiology of this neurohormone and the available evidence in favor of its use as a vasodilator for children in shock. ⋯ The evidence is restricted. Most studies are retrospective and include a small number of patients. Nevertheless, there is significant experience concerning the use of vasopressin in Pediatrics. Vasopressin has a beneficial clinical effect in children and can be indicated in the treatment of refractory vasodilatory shock, after adequate volume resuscitation and when high doses of other vasopressors are not effective.
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Jornal de pediatria · Nov 2007
ReviewGlycemic control and insulin therapy in sepsis and critical illness.
To review the literature about the pathophysiology of hyperglycemia and glycemic control in children and adults with sepsis and critical illness. ⋯ Glycemic control is a novel therapeutic option in critical care. Conflicting evidence in adults means that before we apply this approach to pediatrics it will need to be assessed in clinical trial.
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To review diagnostic criteria and treatment of adrenal insufficiency in pediatric patients with severe sepsis and septic shock. ⋯ Adrenal insufficiency is common in children with severe sepsis and septic shock and may contribute to the development of catecholamine-refractory shock. However, doubts still persist regarding the efficacy of replacement therapy with low-doses steroids.