Pediatr Crit Care Me
-
Pediatr Crit Care Me · Jan 2006
Comparative StudyInfrared tympanic thermometry in comparison with other temperature measurement techniques in febrile children.
: To determine whether infrared tympanic thermometry (ITT) measurements more accurately reflect core body temperatures than axillary, forehead, or rectal measurements during fever cycles in children. ⋯ : ITT measurements more accurately reflect core temperatures than any other measurement site during febrile and nonfebrile periods in children. ITT measurements are a reproducible and relatively noninvasive substitute for bladder or rectal measurements in febrile children.
-
Neonatal mortality and morbidity are sex biased in low birth weight infants. The "Y chromosome effect" has been suggested to be responsible for these maturational differences. ⋯ Bilirubin, IVH, and death were significantly higher in male infants. In subgroup analysis, significance was retained in group A (<1000 g). Whether a single biological factor is responsible for these differences or perhaps a multi-causal process involving a complex interaction of physiologic, environmental, and pathologic responses needs to be further addressed in future research.
-
Pediatr Crit Care Me · Jan 2006
Clinical TrialA prospective pilot study of prophylactic treatment of preterm neonates with recombinant activated factor VII during the first 72 hours of life.
Intraventricular hemorrhage (IVH) in the preterm infant is a devastating complication, causing marked mortality and morbidity. A general hemostatic agent such as recombinant activated factor VII (rFVIIa) might have the potential to reduce the extent of severe IVH. ⋯ One hundred microg/kg rFVIIa does not accumulate if administered prophylactically to preterm infants of <28 wks of gestation every 4 hrs in the first 72 hrs of life. In this population, rFVIIa does not cause DIC. Thrombus formation was observed in two infants with umbilical artery catheters but in none of the infants with venous catheters. Embolic events were not observed. In this pilot study, which did not provide the sample size to assess any effect of rFVIIa on the incidence of IVH, 20% of the neonates went on to have grade III or IV IVH, which is similar to the rate in studies in which rFVIIa was not given.
-
To report the occurrence of bradycardia associated with the use of methadone administered to prevent withdrawal in an infant with physical tolerance following long-term opioid therapy in the pediatric intensive care unit setting. ⋯ Methadone's three-dimensional structure shares similarities with calcium channel antagonists. Although it has been reported in the adult literature, there are no previous reports of bradycardia occurring with methadone therapy in infants. Although there were no deleterious physiologic effects related to the bradycardia in our patient, methadone should be used cautiously in patients who may not tolerate alterations in heart rate.
-
Cyanide intoxication is an extremely rare event. We report a case of a teenager presenting with unresponsiveness, hemodynamic instability, and profound anion gap metabolic acidosis secondary to elevated lactate levels. It was later confirmed that he was a victim of cyanide poisoning. ⋯ Cyanide poisoning is a rare and potentially fatal event. Prompt recognition of its possibility in a critically ill patient can lead to early intervention with antidote therapy and decrease the extent of morbidity and mortality.