Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2012
Case ReportsThe critically ill patient with ataxia-telangiectasia: a case series.
To describe the presentation, clinical course, and outcomes of critically ill patients with ataxia-telangiectasia. ⋯ Critically ill patients with ataxia-telangiectasia have complex, multisystem diseases. In this case series, the most common intensive care unit admission diagnosis was respiratory failure. Suspected or confirmed bacterial infections were prevalent. Neuropathologic autopsy findings were similar to those previously reported. Special considerations for the critical care of patients with ataxia-telangiectasia are discussed.
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Pediatr Crit Care Me · Mar 2012
Bias flow does not affect ventilation during high-frequency oscillatory ventilation in a pediatric animal model of acute lung injury.
During high-frequency oscillatory ventilation, bias flow is the continuous flow of gas responsible for replenishing oxygen and removing CO(2) from the patient circuit. Bias flow is usually set at 20 L/min, but many patients require neuromuscular blockade at this flow rate. The need for neuromuscular blockade may be eliminated by increasing the bias flow rate, but CO(2) retention is a potential concern. We hypothesize that in a swine model of acute lung injury, increased bias flow rates will not affect CO(2) elimination. ⋯ Changes in bias flow during high-frequency oscillatory ventilation did not affect ventilation. Further clinical investigation is ongoing in infants and children with acute lung injury being managed with high-frequency oscillatory ventilation to assess the impact of alterations of bias flow on gas exchange, cardiopulmonary parameters, sedation requirements, and other clinical outcomes.
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Pediatr Crit Care Me · Mar 2012
Association between high cytokine levels with white matter injury in preterm infants with sepsis.
To examine the association among interleukin-6, interleukin-8, tumor necrosis factor-α, interleukin-10, and interleukin-1β and white matter injury in very-low-birth-weight infants with clinical sepsis and to help predict infants at risk for development of white matter injury. ⋯ Very-low-birth-weight infants with proven early-onset sepsis, necrotizing enterocolitis, and high plasma levels of interleukin-6, interleukin-8, and tumor necrosis factor-α are at high risk for white matter injury.
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Pediatr Crit Care Me · Mar 2012
Importance of NOD2/CARD15 gene variants for susceptibility to and outcome of sepsis in Turkish children.
Severe sepsis remains a leading cause of morbidity and mortality in children. Given the link to pathogenesis, polymorphisms in genes involved in infection and inflammation may influence the outcomes in patients with sepsis and septic shock. The role of mutations within the innate immunity receptor NOD2/CARD15 has recently been demonstrated as a risk factor for bacteremia and mortality in adult patients with sepsis. The aim of this study was to evaluate the role of mutations of the NOD2/CARD15 gene in pediatric patients with sepsis. ⋯ The present article is the first report of clinical implications of NOD2/CARD15 gene variants in children with sepsis. Our findings suggest that common polymorphisms in the NOD2/CARD15 gene may play a major role in susceptibility to sepsis and the outcome of sepsis in children.
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Pediatr Crit Care Me · Mar 2012
High mortality in patients with influenza A pH1N1 2009 admitted to a pediatric intensive care unit: a predictive model of mortality.
To describe the clinical characteristics and outcome of patients admitted to pediatric intensive care with influenza A (pH1N1) 2009 in Argentina. ⋯ The mortality of children admitted to the pediatric intensive care unit with 2009 pH1N1 influenza was high (47%) in our population. Age <24 months, asthma, respiratory coinfection, need of mechanical ventilation, and treatment with inotropes were predictors of poorer outcome.