Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2003
Randomized Controlled Trial Clinical TrialErythropoietin therapy in children with bronchiolitis and anemia.
Critically ill children with bronchiolitis often require red blood cell transfusions. Anemia normally results in increased circulating erythropoietin concentrations; however, critical illness has been associated with a blunted erythropoietin response. Treatment with erythropoietin decreases the need for red blood cell transfusion in several disease states. We hypothesized that critically ill children with bronchiolitis and anemia would have a circulating erythropoietin deficiency and that treatment with exogenous erythropoietin would increase reticulocyte count and hematocrit and reduce red blood cell transfusion requirements. ⋯ Despite a favorable reticulocyte and circulating erythropoietin response, red blood cell transfusion requirements were not significantly diminished by erythropoietin treatment in children with bronchiolitis and respiratory failure. Erythropoietin cannot be routinely recommended for this patient population.
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Pediatr Crit Care Me · Jan 2003
Case ReportsExtracorporeal life support as a treatment of supraventricular tachycardia in infants.
There have been few reports of the use of extracorporeal life support (ECLS) to provide cardiac support in children with low cardiac output as a result of arrhythmias. We present two patients in whom venoarterial ECLS was used to provide support for cardiogenic shock secondary to intractable supraventricular tachycardia. In both cases, the arrhythmia terminated once bypass was established. In one case, the time on ECLS was used to optimize drug treatment, and in the other case, radiofrequency ablation was successfully undertaken during ECLS.
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Pediatr Crit Care Me · Jan 2003
Prospective study of potassium-associated acute transfusion events in pediatric intensive care.
Transfusion of packed red blood cells containing high concentrations of potassium have been associated with fetal and neonatal arrhythmia and hyperkalemic cardiac arrest. This study sought to determine the biochemical and associated clinical effects of packed red blood cells transfusion in critically ill children. ⋯ This prospective study found no significant change in patient potassium concentration and no acute adverse events related to transfusion in critically ill children, including those receiving packed red blood cells by bolus. Larger prospective studies are required to evaluate the acute effects of rapid and central venous transfusion in critically ill children.
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Pediatr Crit Care Me · Jan 2003
Jugular venous oxygen saturation or arteriovenous difference of lactate content and outcome in children with severe traumatic brain injury.
To assess the association between neurologic out-come and the alterations of jugular venous oxygen saturation (SjvO2) or the increase in arteriovenous difference of lactate content (AVDL) in children with severe traumatic brain injury. ⋯ In children with severe traumatic brain injury, two or more measurements of SjvO2 of < or = 55% or two or more pathologic AVDL measurements were associated with a poor neurologic outcome. Further studies are needed to recommend the use of these variables as a guideline to optimize treatment.