Journal of paediatrics and child health
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J Paediatr Child Health · Jul 2008
ReviewWithdrawal and limitation of life-sustaining treatments in a paediatric intensive care unit and review of the literature.
To examine withdrawal and limitation of life-sustaining treatment (WLST) in an Australian paediatric intensive care unit (PICU) and to compare this experience with published data from other countries. ⋯ Withdrawal and limitation of life-sustaining treatment was more common in an Australian children's hospital ICU than has been reported from other countries. Details of discussion with parents, including the basis for any decision to WLST, were almost always documented in the patient's medical record.
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J Paediatr Child Health · Jan 2008
Review Meta AnalysisAcute treatment of paediatric migraine: a meta-analysis of efficacy.
To undertake a meta-analysis of all randomised controlled trials (RCTs) on the acute pharmacologic treatment of children and adolescents with migraine headache. ⋯ Despite the pharmacological options for the management of acute migraine, few RCTs in the paediatric population exist. Composite data demonstrate that only ibuprofen and sumatriptan are significantly more effective than placebo in the generation of headache relief in children and adolescents.
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J Paediatr Child Health · Apr 2007
ReviewLegal basis for ethical withholding and withdrawing life-sustaining medical treatment from infants and children.
Withholding and withdrawing life-sustaining medical treatment is common in hospitals, particularly in intensive care unit environments. Usually, decisions regarding limitation of therapy are based on ethical considerations and derived by discussion and mutual agreement between parents and clinicians. However, disputes sometimes arise. ⋯ These are based on the present and future 'quality of life', 'futility' of present treatment and a comparison of 'burdens versus benefits' of present and future treatment and its discontinuance. These legal principles may facilitate difficult ethical decisions. This article identifies a number of common law cases which establishes these principles.
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New Australian Neonatal Resuscitation Guidelines highlight the recent advances in neonatal resuscitation. Resuscitation should start with air and only use oxygen if the infant does not respond. CPAP and PEEP should be considered for premature infants with meconium stained liquor. ⋯ Infants less than 28 weeks gestation should be placed in a polyethylene bag or wrap to keep warm. Chest compressions, when required, remain at 3:1 inflation. The endotracheal tube position must be verified with a carbon dioxide detector.
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J Paediatr Child Health · Dec 1999
Review Case ReportsClinical manifestations of Bacillus cereus meningitis in newborn infants.
Bacillus cereus (B. cereus) meningitis sometimes occurs in patients with risk factors, which are associated with central nervous system (CNS) anomalies, surgical or anaesthetic access to CNS. We observed two cases of B. cereus meningitis in neonates without such risk factors. ⋯ According to the previous neonatal case reports and our experience, we found that six of seven neonates were premature babies admitted to the neonatal intensive care unit, five died within a week of onset of the disease, and six had intracranial haemorrhage. We speculate that B. cereus meningitis may occur in neonates, even without any of the risk factors previously described in adult case reports, and that the clinical manifestations of the meningitis might be characterized by the high incidence of intracranial haemorrhage and poor mortality.