Management of Pediatric Severe Traumatic Brain Injury: 2019 Consensus and Guidelines-Based Algorithm for First and Second Tier Therapies
Conclusions: This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects a logical approach to mitigate intracranial hypertension, optimize cerebral perfusion, and improve outcomes in the setting of pediatric severe traumatic brain injury.
There are multiple learning tools used as an adjunctive aide memoire. Herewith a collection of Toxicological related mnemonics used with varying frequency throughout the conundrums. Let us know if you have any more to add... The post Toxicology Mnemonic Challenge appeared first on Life in the Fast Lane • LITFL • Medical Blog.
In this study, we examined the benefits of early-onset, lifelong AET on predictors of health, inflammation, and cancer incidence in a naturally aging mouse model. Lifelong, voluntary wheel-running (O-AET; 26-month-old) prevented age-related declines in aerobic fitness and motor coordination vs. age-matched, sedentary controls (O-SED). AET also provided partial protection against sarcopenia, dynapenia, testicular atrophy, and overall organ pathology, hence augmenting the 'physiologic reserve' of lifelong runners. Systemic inflammation, as evidenced by a chronic elevation in 17 of 18 pro- and anti-inflammatory cytokin...
Conclusions: Hypothermia shifts oxygen-hemoglobin dissociation curve to the left resulting in lower PaO2 for pulse oximetry. Monitoring oxygenation with arterial blood gas uncorrected for body temperature and pulse oximetry may underestimate hypoxemia in hypoxic-ischemic encephalopathy infants during whole-body hypothermia, while end-tidal CO2 reliably correlates with temperature-corrected PaCO2.
While Wilms tumors (WT) typically present solely with an abdominally palpable mass, rare cases exhibiting vascular tumor growth can also present with circulatory problems. Here, we report the case of a 2.5-year-old girl presenting with upper venous congestion and arterial hypertension as the primary symptoms of intraventricular tumor growth exhibiting remarkable tubular and perfused morphology. Clinical situation stabilized after initiation of neoadjuvant chemotherapy (NAC) with actinomycin D and vincristine, followed by surgical resection via laparotomy and sternotomy supported by cardiopulmonary bypass and deep hypotherm...
CONCLUSIONS: Use of clinical decision support in pediatric traumatic brain injury anesthesia care is feasible, reliable, and may have the potential to improve key performance indicator outcomes. This observational study suggests the possibility of clinical decision support as a strategy to reduce second insults and improve traumatic brain injury guideline adherence during pediatric anesthesia care. This article is protected by copyright. All rights reserved. PMID: 30609176 [PubMed - as supplied by publisher]
Conclusions: Hydrogen inhaling was superior to mild hypothermia for improving neurological outcome and survival in cardiac arrest and resuscitation model of systemic hypertension rats.
Authors: Pan L, Tan S, Cao L, Feng X Abstract Background: To investigate and analyze the risk factors of operating room-related infections after coronary artery bypass grafting (CABG), to propose corresponding infection control management strategies, and to verify and evaluate the effectiveness of the strategy implementation. Methods: Patients with coronary heart disease who underwent CABG in a hospital from January 2015 to December 2016 were selected for inclusion in this study. The following patient variables were documented: demographics, history of underlying diseases (hypertension and diabetes), preoperati...
CONCLUSION: Low-cost devices are safe and effective alternatives for maintaining TH in low-resource settings with adequate monitoring. ABBREVIATIONS: DAMA, discharged against medical advice; DIC, disseminated intravascular coagulation; HELIX, Hypothermia for Encephalopathy in Low- and Middle-Income Countries Trial; HIE, hypoxic ischaemic encephalopathy; IP, ice packs; LMIC, low- and middle-income countries; NICHD, National Institute of Child Health and Human Development; PCM, phase changing; TH, therapeutic hypothermia (TH); TOBY, total body hypothermia for neonatal encephalopathy. PMID: 30109814 [PubMed - as supplied by publisher]
CONCLUSION: In patients who labor, maternal obesity is an independent risk factor for significant neonatal morbidity, even in the absence of hypertensive disorders or diabetes. PMID: 30130347 [PubMed - as supplied by publisher]
Publication date: September 2018Source: Archives of Cardiovascular Diseases Supplements, Volume 10, Issues 3–4Author(s): Stéphanie Delange, Jean-Benoît Thambo, Zakaria Jalal, Jean-Baptiste Mouton, Xavier Iriart, Pierre-Emmanuel SéguélaBackgroundAfter congenital heart surgery, delayed sternal closure (DSC) can be used electively to aid in hemodynamic and respiratory stability in the initial postoperative period. Risk factors for DSC have been previously determined for neonates. The purpose of our study was to determine risk factors that may predict the need for DSC in children