Pediatr Crit Care Me
-
Pediatr Crit Care Me · May 2010
Change in blood-brain barrier permeability during pediatric diabetic ketoacidosis treatment.
Cerebral edema is a devastating complication of pediatric diabetic ketoacidosis. We aimed to examine blood-brain barrier permeability during treatment of diabetic ketoacidosis in children. ⋯ Overall, whole brain and regional blood-brain barrier permeability increased in most subjects during diabetic ketoacidosis treatment. The frontal region had more blood-brain barrier permeability than other brain regions examined.
-
Pediatr Crit Care Me · May 2010
Case ReportsOmphalocele and alveolar capillary dysplasia: a new association.
First report of an infant with coexistent omphalocele and alveolar capillary dysplasia. ⋯ This is the first description of an association between omphalocele and alveolar capillary dysplasia. In newborns with omphalocele who have severe respiratory insufficiency and pulmonary hypertension, alveolar capillary dysplasia should be considered.
-
Pediatr Crit Care Me · May 2010
The effect of blood transfusion on brain oxygenation in children with severe traumatic brain injury.
The indications for blood transfusion in traumatic brain injury are controversial. In particular, little is known about the effect of blood transfusion in childhood traumatic brain injury. This study aimed to examine the influence of blood transfusion on brain tissue oxygen tension in children with severe traumatic brain injury. ⋯ Brain tissue oxygen tension increased transiently in 79% of blood transfusion in pediatric traumatic brain injury patients, and decreased transiently in 21%. Brain tissue oxygen tension returned to baseline within 24 hrs. Reliable predictors of this brain tissue oxygen tension response to blood transfusion, however, remain elusive.
-
Pediatr Crit Care Me · May 2010
Building trust through communication in the intensive care unit: HICCC.
The goal of this study was to explore the role of communication in building trust between intensivists and parents in the pediatric intensive care unit. ⋯ Communication is vital to building trust in the pediatric intensive care unit. Developed from parents' own observations and perspectives, HICCC is an accessible framework that can help doctors to remember what parents value in communication in the acute care setting. In addition, pediatric intensivists would benefit from targeted cultural competency training to reduce physician bias.
-
Pediatr Crit Care Me · May 2010
Case ReportsTherapeutic bilateral lung lavage in a child with pulmonary alveolar proteinosis.
Pulmonary alveolar proteinosis is a rare condition that can cause life-threatening respiratory failure attributable to excessive alveolar accumulation of surfactant proteins. The standard treatment for removing these secretions is through therapeutic bilateral lung lavage. Descriptions of procedures for performing therapeutic bilateral lung lavage and methods used to evaluate the overall effectiveness of this invasive procedure in children with pulmonary alveolar proteinosis have not been adequately described in the medical literature. We successfully and safely performed therapeutic bilateral lung lavage and obtained lung mechanics measurements in a child with pulmonary alveolar proteinosis. ⋯ This case report demonstrates that therapeutic bilateral lung lavage can be performed safely and effectively in a pediatric patient with pulmonary alveolar proteinosis by isolating individual lungs using a dual-lumen endotracheal tube. In this patient, therapeutic bilateral lung lavage was found to have a significant impact on lung function and mechanics after this procedure.