Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.10.012
S. Zhuang
Fulminant myocarditis is characterized by acute hemodynamic disorder, with rapid progress and high mortality.This article reviewed the current diagnostic criteria, the development of diagnostic techniques, as well as the development of current immunological, antiviral, and mechanical circulation adjuvant therapy for fulminant myocarditis in children. Key words: Fulminant myocarditis; Early diagnosis; Therapy; Children
{"title":"Advance on early diagnosis and treatment of fulminant myocarditis in children","authors":"S. Zhuang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.012","url":null,"abstract":"Fulminant myocarditis is characterized by acute hemodynamic disorder, with rapid progress and high mortality.This article reviewed the current diagnostic criteria, the development of diagnostic techniques, as well as the development of current immunological, antiviral, and mechanical circulation adjuvant therapy for fulminant myocarditis in children. \u0000 \u0000 \u0000Key words: \u0000Fulminant myocarditis; Early diagnosis; Therapy; Children","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"777-781"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48161609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.10.007
Wenliang Song
Adenovirus is a common cause of respiratory infection in children and can cause severe pneumonia.Adenovirus can also cause damage to immune system.It can cause decrease in T and B cell number and function, imbalance of Th1/Th2 cell proportion, but also can cause imbalance of proinflammatory cytokines and anti-inflammatory cytokines, further leading to dysfunction of immune system, with severe complications such as severe sepsis and multiple organ and system dysfunction.In this paper we will discuss immune pathogenesis of adenovirus infection and provide suggestion for treatment of adenovirus pneumonia. Key words: Adenovirus pneumonia; Children; Immunology; Treatment
{"title":"Immunological characteristics and treatment of pediatric adenovirus pneumonia","authors":"Wenliang Song","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.007","url":null,"abstract":"Adenovirus is a common cause of respiratory infection in children and can cause severe pneumonia.Adenovirus can also cause damage to immune system.It can cause decrease in T and B cell number and function, imbalance of Th1/Th2 cell proportion, but also can cause imbalance of proinflammatory cytokines and anti-inflammatory cytokines, further leading to dysfunction of immune system, with severe complications such as severe sepsis and multiple organ and system dysfunction.In this paper we will discuss immune pathogenesis of adenovirus infection and provide suggestion for treatment of adenovirus pneumonia. \u0000 \u0000 \u0000Key words: \u0000Adenovirus pneumonia; Children; Immunology; Treatment","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"746-751"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44213548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.09.003
Jing Hu
This article described the main classification of severe drug eruption and its clinical manifestations, summarized the treatment principle of severe drug eruption, including stopping sensitization drugs, hormone therapy, support treatment, anti-infection treatment, etc, and summarized nursing methods of severe drug eruption, including removal of allergens, preventing infection, condition observation, skin care, mucosal care, nutritional supporting, psychological care and health education to provide reference and guidance for the treatment and nursing of severe drug eruption. Key words: Severe drug eruption; Treatment; Nursing
{"title":"Nursing of severe drug eruption in children","authors":"Jing Hu","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.003","url":null,"abstract":"This article described the main classification of severe drug eruption and its clinical manifestations, summarized the treatment principle of severe drug eruption, including stopping sensitization drugs, hormone therapy, support treatment, anti-infection treatment, etc, and summarized nursing methods of severe drug eruption, including removal of allergens, preventing infection, condition observation, skin care, mucosal care, nutritional supporting, psychological care and health education to provide reference and guidance for the treatment and nursing of severe drug eruption. \u0000 \u0000 \u0000Key words: \u0000Severe drug eruption; Treatment; Nursing","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"652-655"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46564756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.09.011
Jinglin Xu, Bin Wu
Necrotizing enterocolitis(NEC)is the most important gastrointestinal emergency of preterm neonates in neonatal intensive care units.The diagnosis of NEC is difficult during its earliest stages.Looking for all early specific biological indicators to recognize cases during its earliest stages is important.Fecal calprotectin, as a simple and noninvasive test index, has been widely used in inflammatory diseases in adults and children.Studies have shown that fecal calprotectin is significantly higher in newborns with NEC, which can be used as an screening marker for the detection of NEC or an indicator to predict the occurrence and severity of the disease.This review summarized the characteristics of fecal calprotectin in neonates and its clinical significance as a noninvasive marker of necrotizing enterocolitis. Key words: Calprotectin; Necrotizing enterocolitis; Infant, newborn
{"title":"Application value of fecal calprotectin in necrotizing enterocolitis","authors":"Jinglin Xu, Bin Wu","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.011","url":null,"abstract":"Necrotizing enterocolitis(NEC)is the most important gastrointestinal emergency of preterm neonates in neonatal intensive care units.The diagnosis of NEC is difficult during its earliest stages.Looking for all early specific biological indicators to recognize cases during its earliest stages is important.Fecal calprotectin, as a simple and noninvasive test index, has been widely used in inflammatory diseases in adults and children.Studies have shown that fecal calprotectin is significantly higher in newborns with NEC, which can be used as an screening marker for the detection of NEC or an indicator to predict the occurrence and severity of the disease.This review summarized the characteristics of fecal calprotectin in neonates and its clinical significance as a noninvasive marker of necrotizing enterocolitis. \u0000 \u0000 \u0000Key words: \u0000Calprotectin; Necrotizing enterocolitis; Infant, newborn","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"691-695"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47186063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this article is to describe the current outcome of multiple organ dysfunction syndrome (MODS) in PICU on the first day of admission. Design: Retrospective observational cohort study site: Admission records from the Virtual Pediatric Systems (VPS) database between January 2014 and December 2015. Object: This article analyzed 194017 consecutive PICU admitted children (aged 1 month to 18 years) in the VPS database from January 2014 to December 2015. Intervention: This article adopts the standards of the International Pediatric Sepsis Consensus Conference to confirm the MODS on Day 1 based on laboratory and vital sign values on Day 1. Evaluate functional status through the Pediatric Overall Performance Classification (POPC) and Pediatric Brain Function Classification (PCPC) scores at PICU admission and discharge. Measurement method and main results: The overall mortality rate of PICU was 2.1%. This article confirms that 14.4% of admitted cases develop MODS on the first day. The mortality rate of MODS patients is higher than that of non MODS patients (10.3% vs 0.7%, P<0.001), and the proportion of surviving patients with PCPC (3.6% vs 0.5%, P<0.001) or POPC (6.0% vs 1.8%, P<0.001) score deterioration ≥ grade 2 is higher. The odds ratio of mortality in MODS patients on the first day was 14.3 (95% CI 13-15.7), while the odds ratio of death or discharge with a POPC/CPC score of ≥ 3 (poor functional prognosis) was 6.7 (95% CI 6-7.4). The research subset was from 148 188 pediatric patients who recorded restrictive support decision hospitals, which was found in 5.8% of MODS patients, while only 0.8% of patients without MODS (P<0.001). On the first day of death, 43.1% of MODS patients received restrictive support decisions, and 41.6% gave up life support treatment (P<0.001). Conclusion: MODS patients on the first day of admission are still the main source of mortality and disability in PICU, but the risk of poor neurological prognosis may be improved. Further research is needed on restrictive support strategies and decisions to discontinue life support therapy in children with MODS on day 1.
{"title":"Outcomes of Day 1 Multiple Organ Dysfunction Syndrome in the Pediatric Intensive Care Unit","authors":"方伯梁, 钱素云","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.102","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.102","url":null,"abstract":"目的 \u0000本文旨在描述PICU入院第1天出现多器官功能障碍综合征(multiple organ dysfunction syndrome，MODS)的结局现状。 \u0000 \u0000 \u0000设计： \u0000回顾性观察性队列研究 \u0000 \u0000 \u0000场所： \u00002014年1月至2015年12月间虚拟儿科系统(Virtual Pediatric Systems，VPS)数据库的入院记录。 \u0000 \u0000 \u0000对象： \u0000本文分析了2014年1月至2015年12月VPS数据库中的194 017个连续PICU入院患儿(年龄1个月～18岁)。 \u0000 \u0000 \u0000干预： \u0000本文采用国际儿科脓毒症共识会议标准按照第1天实验室和生命体征数值确认第1天MODS。通过PICU入院和出院时的儿科总体表现分类(POPC)和儿科脑功能表现分类(PCPC)评分评估功能状况。 \u0000 \u0000 \u0000测量方法和主要结果： \u0000PICU总体病死率2.1%。本文确认14.4%入院病例第1天发生MODS。MODS患儿病死率高于无MODS者(10.3%比0.7%，P<0.001)，存活者PCPC(3.6%比0.5%，P<0.000 1)或POPC(6.0%比1.8%，P<0.001)评分恶化≥2级比例更高。第1天发生MODS患儿病死的优势比为14.3(95%CI 13-15.7)，而病死或出院时POPC/PCPC评分≥3(功能预后差)的优势比为6.7(95%CI 6-7.4)。研究子集来自记录限制性支持决策医院的148 188例患儿，该决策见于5.8%MODS患儿，而无MODS者仅0.8%(P<0.001)。病死的第1天MODS患儿中，43.1%接受限制性支持决策，41.6%放弃生命维持治疗(P<0.001)。 \u0000 \u0000 \u0000结论： \u0000入院第1天MODS患儿仍是PICU中病死和残疾的主要病例来源，但神经预后不良的风险可能会得到改善。需要进一步研究第1天MODS患儿的限制性支持策略和停止生命维持治疗的决策。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"675-675"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44408997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.09.002
Wenmin Lu
The epidemiology, clinical manifestations and appropriate diagnostic methods of drug eruption in children are still poorly understood.On the one hand, children′s adverse reactions to drugs are different from adults because of their weight and age characteristics.On the other hand, they can mimic many other skin diseases, especially viral exanthems, frequently appearing as a maculopapular or morbilliform rash sometimes indistinguishable from a cutaneous adverse drug reaction.Meanwhile, the tools used for drug eruption management in adults are applied also for children.Whereas this appears generally acceptable, some aspects of drug eruption and management differ with age.The pathogenesis of drug eruption in children is related to virus infection, immune state, drug and metabolic enzyme effect.Most reactions in children are still attributed to betalactams.The practicability and validity of skin test and other diagnostic procedures need further assessment in children.The key to treatment is early diagnosis, discontinuation of suspect drugs, assessment of prognosis, and specialist support. Key words: Drug eruption; Drug allergy; Children
{"title":"Drug eruption in children","authors":"Wenmin Lu","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.002","url":null,"abstract":"The epidemiology, clinical manifestations and appropriate diagnostic methods of drug eruption in children are still poorly understood.On the one hand, children′s adverse reactions to drugs are different from adults because of their weight and age characteristics.On the other hand, they can mimic many other skin diseases, especially viral exanthems, frequently appearing as a maculopapular or morbilliform rash sometimes indistinguishable from a cutaneous adverse drug reaction.Meanwhile, the tools used for drug eruption management in adults are applied also for children.Whereas this appears generally acceptable, some aspects of drug eruption and management differ with age.The pathogenesis of drug eruption in children is related to virus infection, immune state, drug and metabolic enzyme effect.Most reactions in children are still attributed to betalactams.The practicability and validity of skin test and other diagnostic procedures need further assessment in children.The key to treatment is early diagnosis, discontinuation of suspect drugs, assessment of prognosis, and specialist support. \u0000 \u0000 \u0000Key words: \u0000Drug eruption; Drug allergy; Children","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"647-651"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44673803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.09.010
Y. Wan, Shuqing Zhang, Dongmei Yue
Objective To study the clinical effect of inhaled nitric oxide(iNO) with mechanical ventilation for the neonates with persistent pulmonary hypertension of newborn(PPHN). Methods A total of 40 neonates with PPHN poorly responding with routine treatment were treated with iNO therapy.Pulmonary artery pressure, blood gas ion analysis and respiratory function changes were observed at different time points before and after iNO. Results Treatment with iNO resulted in a rapid decrease in pulmonary artery pressure from(54.95±17.08) mmHg(1 mmHg=0.133 kPa) to(20.40±14.26) mmHg.Oxygenation of 40 cases improved in the first 0.5~1 hour after iNO therapy, the values of mean airway pressure(MAP)declined from(13.98±2.40)cmH2O(1 cmH2O=0.098 kPa) to(12.44±2.69)cmH2O, oxygenation index(OI)decreased from 26.89±18.62 to 13.84±5.52, PaO2/FiO2 increased from(60.34±23.49) mmHg to(144.46±23.49) mmHg, and the value of pH increased from 7.31±0.14 to 7.37±0.07.Furthermore, within 48 hours after treatment, PaO2/FiO2 and pH increased gradually, while MAP and OI decreased gradually, which all had statistical differences(P<0.01). Conclusion Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the oxygenation status of neonates, reduce pulmonary vascular resistance, and then improve the survival rate and long-term prognosis. Key words: Mechanical ventilation; Inhaled nitric oxide; Persistent pulmonary hypertension of newborn
{"title":"Effect of inhaled nitric oxide with mechanical ventilation in persistent pulmonary hypertension of newborn","authors":"Y. Wan, Shuqing Zhang, Dongmei Yue","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.010","url":null,"abstract":"Objective \u0000To study the clinical effect of inhaled nitric oxide(iNO) with mechanical ventilation for the neonates with persistent pulmonary hypertension of newborn(PPHN). \u0000 \u0000 \u0000Methods \u0000A total of 40 neonates with PPHN poorly responding with routine treatment were treated with iNO therapy.Pulmonary artery pressure, blood gas ion analysis and respiratory function changes were observed at different time points before and after iNO. \u0000 \u0000 \u0000Results \u0000Treatment with iNO resulted in a rapid decrease in pulmonary artery pressure from(54.95±17.08) mmHg(1 mmHg=0.133 kPa) to(20.40±14.26) mmHg.Oxygenation of 40 cases improved in the first 0.5~1 hour after iNO therapy, the values of mean airway pressure(MAP)declined from(13.98±2.40)cmH2O(1 cmH2O=0.098 kPa) to(12.44±2.69)cmH2O, oxygenation index(OI)decreased from 26.89±18.62 to 13.84±5.52, PaO2/FiO2 increased from(60.34±23.49) mmHg to(144.46±23.49) mmHg, and the value of pH increased from 7.31±0.14 to 7.37±0.07.Furthermore, within 48 hours after treatment, PaO2/FiO2 and pH increased gradually, while MAP and OI decreased gradually, which all had statistical differences(P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the oxygenation status of neonates, reduce pulmonary vascular resistance, and then improve the survival rate and long-term prognosis. \u0000 \u0000 \u0000Key words: \u0000Mechanical ventilation; Inhaled nitric oxide; Persistent pulmonary hypertension of newborn","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"687-690"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42190123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.09.005
Tianyu Li, Dajia Wang, W. Xu, Chunfeng Liu, Weilin Wang
Objective To summarize the technical experience of extracorporeal membrane oxygenation(ECMO)catheterization in children. Methods Data of patients that received ECMO treatment in the pediatric intensive care unit between October 2016 and October 2018 were analyzed retrospectively.The age, weight, diagnosis, complications and the final outcomes of the patients, as well as the working mode, catheterization mode and duration of ECMO were collected. Results A total of 15 children were treated with ECMO, including 5 males and 10 females.The median age(range) was 4.9 (1.0-11.0)years and the median weight(range) was 21.5(8.5-49.0)kg.There were 5 cases of fulminant myocarditis, 7 cases of severe pneumonia, 3 cases of septic shock, 8 cases of venous-arterial bypass(VA mode), and 7 cases of venous-venous bypass(VV mode). All the 15 patients underwent percutaneous catheterization.Two patients that experienced difficulty in percutaneous catheterization turned to open catheterization.None abandoned ECMO due to the difficulty in catheterization.The position and depth of the catheter, and the flow rate required no further adjustment.The mean ECMO duration was 96.8(1-366)h.Weaning was successful in 8 cases(53%). One case was transferred and 8 cases were dismissed, and the survival rate was 60%.There were 2 cases of bleeding at the site of catheter entrance, one treated with local compression and the other with suture.There was 1 case of femoral artery thrombosis that was relieved by percutaneous femoral artery angiography and intracavitary formation.Another case developed carotid artery thrombosis and had been undergoing antithrombotic therapy and following-up.One case had nerve injury in the left lower extremity that was relieved by oral vitamin Bs and low frequency electrical stimulation. Conclusion Catheterization is the basis of ECMO execution.Catheterization method should be individualized.Percutaneous catheterization is the choice of thumb due to its safety and simplicity.In case of failure, or during the extra-cardiac compression, the surgical method should be taken quickly, and the catheter should be placed in an open or partly-open manner.Proficient catheterization technique ensures the smooth application of ECMO in children. Key words: Cannulation technique; Extracorporeal membrane oxygenation; Children
{"title":"Extracorporeal membrane oxygenation catheterization in critically ill children","authors":"Tianyu Li, Dajia Wang, W. Xu, Chunfeng Liu, Weilin Wang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.005","url":null,"abstract":"Objective \u0000To summarize the technical experience of extracorporeal membrane oxygenation(ECMO)catheterization in children. \u0000 \u0000 \u0000Methods \u0000Data of patients that received ECMO treatment in the pediatric intensive care unit between October 2016 and October 2018 were analyzed retrospectively.The age, weight, diagnosis, complications and the final outcomes of the patients, as well as the working mode, catheterization mode and duration of ECMO were collected. \u0000 \u0000 \u0000Results \u0000A total of 15 children were treated with ECMO, including 5 males and 10 females.The median age(range) was 4.9 (1.0-11.0)years and the median weight(range) was 21.5(8.5-49.0)kg.There were 5 cases of fulminant myocarditis, 7 cases of severe pneumonia, 3 cases of septic shock, 8 cases of venous-arterial bypass(VA mode), and 7 cases of venous-venous bypass(VV mode). All the 15 patients underwent percutaneous catheterization.Two patients that experienced difficulty in percutaneous catheterization turned to open catheterization.None abandoned ECMO due to the difficulty in catheterization.The position and depth of the catheter, and the flow rate required no further adjustment.The mean ECMO duration was 96.8(1-366)h.Weaning was successful in 8 cases(53%). One case was transferred and 8 cases were dismissed, and the survival rate was 60%.There were 2 cases of bleeding at the site of catheter entrance, one treated with local compression and the other with suture.There was 1 case of femoral artery thrombosis that was relieved by percutaneous femoral artery angiography and intracavitary formation.Another case developed carotid artery thrombosis and had been undergoing antithrombotic therapy and following-up.One case had nerve injury in the left lower extremity that was relieved by oral vitamin Bs and low frequency electrical stimulation. \u0000 \u0000 \u0000Conclusion \u0000Catheterization is the basis of ECMO execution.Catheterization method should be individualized.Percutaneous catheterization is the choice of thumb due to its safety and simplicity.In case of failure, or during the extra-cardiac compression, the surgical method should be taken quickly, and the catheter should be placed in an open or partly-open manner.Proficient catheterization technique ensures the smooth application of ECMO in children. \u0000 \u0000 \u0000Key words: \u0000Cannulation technique; Extracorporeal membrane oxygenation; Children","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"662-665"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43261557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.09.013
Yaya Xu
Central venous pressure (CVP) is one of the most commonly used parameters in hemodynamic monitoring, and monitoring CVP to guide the treatment of acute circulatory failure is a relatively common clinical method.However, many studies have pointed out that CVP is affected by many factors and has great limitations, which cannot provide help for the treatment of acute circulatory failure.This review summarized the analysis of the working principle of CVP, its value in treatment and influencing factors.The main purpose is to get a better understanding of CVP. Key words: Central venous pressure; Acute circulatory failure; Fluid resuscitation; Fluid responsiveness; Cardiac output; Hemodynamics
{"title":"Monitoring center venous pressure to guide the treatment of acute circulatory failure: give up or persist","authors":"Yaya Xu","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.013","url":null,"abstract":"Central venous pressure (CVP) is one of the most commonly used parameters in hemodynamic monitoring, and monitoring CVP to guide the treatment of acute circulatory failure is a relatively common clinical method.However, many studies have pointed out that CVP is affected by many factors and has great limitations, which cannot provide help for the treatment of acute circulatory failure.This review summarized the analysis of the working principle of CVP, its value in treatment and influencing factors.The main purpose is to get a better understanding of CVP. \u0000 \u0000 \u0000Key words: \u0000Central venous pressure; Acute circulatory failure; Fluid resuscitation; Fluid responsiveness; Cardiac output; Hemodynamics","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"701-706"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46097839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1673-4912.2019.09.009
Z. Zhao
Objective To explore the clinical characteristics of multiple magnetic digestive tract foreign bodies ingested by mistake, to review the previous literature and provide reference for clinical treatment. Methods The clinical data, treatment process and outcome of 8 cases of children with multiple magnetic foreign bodies admitted to Shanxi Children′s Hospital were retrospectively analyzed, and relevant literatures were reviewed. Results Eight children with multiple magnets were aged 1 to 9 years old, and their medical history ranged from 5 hours to 2 months.Number of magnets ingested was 2-25.During the operation, 6 patients were found with multiple intestinal perforations, 1 with internal fistula and 2 with internal abdominal hernia, with at least 2 perforations and at most 6 perforations.The perforation sites located in the distal esophagus, stomach, duodenum, jejunum, ileum and colon.Seven cases were treated by emergency surgery, and 1 case was removed by colonoscopy and discharged after conservative treatment.One case underwent simple repair, 1 case underwent gastrojejunostomy, intestinal perforation repair; partial intestinal resection was performed in 2 places in 2 cases; partial intestinal resection was performed in 1 place and simple repair in the other places in 2 case; 1 case of fistula in child with intestinal anastomosis laparoscopic exploration, incision bowel resection.Seven cases recovered after surgical treatment.The child with intestinal obstruction after colonoscopy was discharged uneventfully 9 days later by conservative treatment, no complications occurred by followed-up.Combined with experience and literature, we developed a management algorithm for digestive tract magnet foreign body. Conclusion Accidental ingestion of multiple magnets can cause multiple digestive tract perforations, internal hernia, intestinal obstruction and other serious diseases, which should be treated as soon as possible.Therefore, it is necessary to strengthen the understanding of multiple magnet foreign bodies in children, early detection and early treatment. Key words: Multiple magnet; Digestive tract foreign body; Children
{"title":"Diagnosis and treatment of 8 cases of children ingesting multiple magnetic foreign bodies by mistake","authors":"Z. Zhao","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.09.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.09.009","url":null,"abstract":"Objective \u0000To explore the clinical characteristics of multiple magnetic digestive tract foreign bodies ingested by mistake, to review the previous literature and provide reference for clinical treatment. \u0000 \u0000 \u0000Methods \u0000The clinical data, treatment process and outcome of 8 cases of children with multiple magnetic foreign bodies admitted to Shanxi Children′s Hospital were retrospectively analyzed, and relevant literatures were reviewed. \u0000 \u0000 \u0000Results \u0000Eight children with multiple magnets were aged 1 to 9 years old, and their medical history ranged from 5 hours to 2 months.Number of magnets ingested was 2-25.During the operation, 6 patients were found with multiple intestinal perforations, 1 with internal fistula and 2 with internal abdominal hernia, with at least 2 perforations and at most 6 perforations.The perforation sites located in the distal esophagus, stomach, duodenum, jejunum, ileum and colon.Seven cases were treated by emergency surgery, and 1 case was removed by colonoscopy and discharged after conservative treatment.One case underwent simple repair, 1 case underwent gastrojejunostomy, intestinal perforation repair; partial intestinal resection was performed in 2 places in 2 cases; partial intestinal resection was performed in 1 place and simple repair in the other places in 2 case; 1 case of fistula in child with intestinal anastomosis laparoscopic exploration, incision bowel resection.Seven cases recovered after surgical treatment.The child with intestinal obstruction after colonoscopy was discharged uneventfully 9 days later by conservative treatment, no complications occurred by followed-up.Combined with experience and literature, we developed a management algorithm for digestive tract magnet foreign body. \u0000 \u0000 \u0000Conclusion \u0000Accidental ingestion of multiple magnets can cause multiple digestive tract perforations, internal hernia, intestinal obstruction and other serious diseases, which should be treated as soon as possible.Therefore, it is necessary to strengthen the understanding of multiple magnet foreign bodies in children, early detection and early treatment. \u0000 \u0000 \u0000Key words: \u0000Multiple magnet; Digestive tract foreign body; Children","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"681-686"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48903143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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