Pediatrics
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Common clinical practices often are unsupported by experimental evidence. One example is the administration of sodium bicarbonate to neonates. ⋯ Indeed, there is evidence that this therapy is detrimental. This review examines the history of sodium bicarbonate use in neonatology and the evidence that refutes the clinical practice of administering sodium bicarbonate during cardiopulmonary resuscitation or to treat metabolic acidosis in the NICU.
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Randomized Controlled Trial Comparative Study
Randomized, controlled trial on tracheal colonization of ventilated infants: can gravity prevent ventilator-associated pneumonia?
The goal was to test the hypothesis that intubated infants positioned on their sides would be less likely to contract bacterial colonization in their tracheae, compared with those positioned supine. ⋯ Respiratory contamination is very common among ventilated infants. Therefore, judicious use of mechanical ventilation cannot be overemphasized. Gravitational force can ameliorate the onset of respiratory colonization. The mechanism and clinical applicability of such observations need to be explored further.
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Multicenter Study Comparative Study
Skin conductance versus the modified COMFORT sedation score as a measure of discomfort in artificially ventilated children.
We wanted to use skin conductance as a measure of increased stress in artificially ventilated children. The aim was to examine how changes in skin conductance, arterial blood pressure, and heart rate are associated with changes in the modified COMFORT sedation score during suction from the trachea. Nociceptive stimulation induces an outgoing sympathetic nervous burst to the skin and the palmar and plantar sweat glands are filled, which creates a skin conductance fluctuation. ⋯ The number of skin conductance fluctuations during endotracheal suctioning showed better correlation with the increase in the modified COMFORT sedation score than heart rate and arterial blood pressure. Thus, the number of skin conductance fluctuations seems to be an objective supplement to the modified COMFORT sedation score for monitoring increased stress in artificially ventilated and circulatory stable children.
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Comparative Study
Procalcitonin in young febrile infants for the detection of serious bacterial infections.
The objectives of the study were (1) to study the test performance of procalcitonin for identifying serious bacterial infections in febrile infants
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Multicenter Study Comparative Study
Influenza-associated pediatric mortality in the United States: increase of Staphylococcus aureus coinfection.
Pediatric influenza-associated death became a nationally notifiable condition in the United States during 2004. We describe influenza-associated pediatric mortality from 2004 to 2007, including an increase of Staphylococcus aureus coinfections. ⋯ Influenza-associated pediatric mortality is rare, but the proportion of S aureus coinfection identified increased fivefold over the past 3 seasons. Research is needed to identify risk factors for influenza coinfection with invasive bacteria and to determine the impact of influenza vaccination and antiviral agents in preventing pediatric mortality.