Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2006
Energy expenditure and balance following pediatric intensive care unit admission: a longitudinal study of critically ill children.
Longitudinal comparison of prescribed energy, actually administered energy, and energy expenditure (EE) predicted by Schofield's equations to actual EE, as determined by daily indirect calorimetry measurements in critically ill children during the first 7 days following admission. ⋯ Measured EE was stable and not significantly different from predicted values over the course of hospitalization. Underfeeding was frequently present and mainly due to prescription and administration of energy amounts inferior to measured EE values in enterally fed patients.
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Pediatr Crit Care Me · Mar 2006
Pulmonary edema in meningococcal septicemia associated with reduced epithelial chloride transport.
To test the hypothesis that meningococcal septicemia-related pulmonary edema is associated with a systemic abnormality of epithelial sodium and chloride transport and to investigate an association with hormones regulating Na transport. ⋯ We have confirmed that meningococcal septicemia-related pulmonary edema is associated with reduced systemic sodium and chloride transport. Features of reduced Cl transport were most closely associated with markers of respiratory compromise, and this was supported by the reduced chloride channel function detected on nasal potential difference measurement.
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Pediatr Crit Care Me · Mar 2006
Cerebral oxygenation in neonatal and pediatric patients during veno-arterial extracorporeal life support.
To observe the effects of right carotid artery ligation and variations in extracorporeal life support (ECLS) flow on regional cerebral oxygenation index (rSO2i) measured using near infrared spectroscopy. ⋯ This study demonstrated no relationship between ECLS flow and rSO2i changes during the 72-hr observation period. A brief period of cerebral oxygen desaturation of the right frontal region at the time of right carotid ligation was seen in all three study patients examined during cannulation, followed by an increased rSO2i with initiation of ECLS flow. Near infrared spectroscopy measurement may offer an important adjunct for neurologic monitoring of ECLS patients.
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Pediatr Crit Care Me · Mar 2006
Use of dexmedetomidine in children after cardiac and thoracic surgery.
In this report, we describe our experience with the use of dexmedetomidine in spontaneously breathing as well as in mechanically ventilated patients, after congenital cardiac and thoracic surgery. ⋯ Our data suggest that dexmedetomidine is a well-tolerated and effective agent for both spontaneously breathing and mechanically ventilated patients following congenital cardiac and thoracic surgery.
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Pediatr Crit Care Me · Mar 2006
Case ReportsAbdominal compartment syndrome contributing to failure of extracorporeal membrane oxygenation in an infant with congenital heart disease and sepsis.
To provide the first account of extracorporeal membrane oxygenation therapy failure secondary to abdominal compartment syndrome. ⋯ Abdominal compartment syndrome is a life-threatening condition resulting from an increase in intra-abdominal pressure that compromises abdominal organ perfusion, pulmonary function, and cardiac output. Mortality rates from abdominal compartment syndrome are as high as 60% in adults and children. This report of an infant with congenital heart disease and E. coli sepsis represents the first description of abdominal compartment syndrome that contributed to failure of extracorporeal membrane oxygenation and ultimately death. The pathophysiology, diagnosis, and treatment of abdominal compartment syndrome are also reviewed.