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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 140 (1983), S. 133-135 
    ISSN: 1432-1076
    Keywords: Status epilepticus ; Thiopentone sodium anaesthesia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 4-month-old infant was admitted to the Pediatric Intensive Care Unit with Pneumococcal meningitis. A few hours after admission he developed intractable convulsions that could not be stopped with phenytoin, phenobarbitone and a continous drip of diazepam. Thiopentone sodium anaesthesia was induced for 24 h terminating the status epilepticus. The clinical course, correlary EEG findings, treatment protocol and blood levels of the drugs given are described in detail.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 11 (1985), S. 20-25 
    ISSN: 1432-1238
    Keywords: Scoring system ; Pediatric intensive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A scoring system to assess disease severity in children, based on therapeutic and diagnostic interventions, is suggested. The charts of 475 consecutive admissions to a multidisciplinary pediatric intensive care unit (PICU) were reviewed and therapeutic and diagnostic interventions (TDI) associated with more than 20% mortality identified. These were scored: TDI associated with 20–30% mortality-1 point; 31–40%-2 points; 41–50%-3 points and more than 51%-4 points. According to these values, a Pediatric Therapeutic and Diagnostic Intervention Score (PTDIS) was calculated for each patient. The study population may be divided, according to PTDIS and mortality, into three groups: moderately severe disease associated with up to 2.7% mortality and PTDIS less than 20; severe disease associated with up to 25% mortality and PTDIS less than 35; critically ill patients with more than 50% mortality and PTDIS greater than 36. PTDIS in survivors was 15.2±0.6 (mean±SE) and 43.6±1.1 in non-survivors. Pearson's correlation between PTDIS and mortality was R=0.7162 at a significance level of p〈0.0001. PTDIS and mortality were not found to be significantly correlated with sex, age or duration of hospitalization in the Unit. Sepsis, central nervous system infections and burns were the primary diseases, and shock, coma and patients after cardiopulmonary resuscitation the indications for admission to the Unit, associated with the highest mortality and PTDIS. This study demonstrates the efficacy of the suggested PTDIS system in accurately assessing severity of disease in a PICU patient population.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 16 (1990), S. 95-99 
    ISSN: 1432-1238
    Keywords: Endotracheal suctioning ; Arterial blood gases ; Respiratory failure ; Hypoxia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The occurrence of hypoxia during endotracheal tube suctioning and its prevention was examined in 25 hemodynamically stable and non-cyanosed pediatric patients. In each patient 4 suction and treatment protocols were studied: 1. pre- and post-suction arterial blood gases (ABG) with no treatment (control). 2. ABG with pre-suction oxygenation. 3. ABG with presuction hyperinflation. 4. ABG with postsuction hyperinflation. With no presuction treatment the PO2 and saturation fell significantly after suctioning from control level of 116.6±9.4 mmHg to 93±9.3 mmHg post-suction and 97.2±0.4% to 92.8±1.4% (p〈0.001) respectively. In 6 patients with low but adequate pre-suction PO2, hypoxic levels (PO2〈60 mmHg) were found post-suction. The significant fall in PO2 was completely prevented by pre-suction oxygenation. Post-suction hyperinflation induced a rapid return of the PO2 to control levels. These results suggest that severe hypoxia might occur during endotracheal suctioning and can be prevented by pre-oxygenation. We recommend 1 min oxygenation with FiO2 1.0 prior to suctioning procedures and intermittent hyperinflation with 100% oxygen during repeated endotracheal suction passes to prevent hypoxia, especially in children in respiratory failure who already have low or borderline pre-suction PO2.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 11 (1985), S. 43-44 
    ISSN: 1432-1238
    Keywords: Mediastinal abscess ; Streptococcus pneumonia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 16-month old baby developed severe respiratory failure because of acute laryngitis and required mechanical ventilation. Intubation was complicated by aspiration and development of chemical pneumonia. Following 4 days of treatment the child was successfully extubated. Thirty six hours after extubation the patient again developed respiratory failure and on chest X-ray pneumomediastinum was seen and later evidence of a mediastinal abscess. Conservative treatment, with antibiotics, effected complete cure.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Journal of neurology 230 (1983), S. 259-266 
    ISSN: 1432-1459
    Keywords: Convulsions, experimental ; Intracranial pressure ; Pentylenetetrazole ; Bicuculline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung An der Katze wurden Versuche durchgeführt, die den Zusammenhang zwischen langdauernden Krämpfen und intrakraniellem Druck klären sollten. Die Anfälle wurden durch Pentylentetrazol oder Bicucullin erzeugt. Blutdruck, intrakranieller Druck und Elektroencephalogramm wurden fortlaufend registriert. Tonisch-klonische Krampfanfälle zugleich mit typischer Veränderung des Elektroencephalogrammes traten 7 bis 35 s nach der Applikation der epileptogenen Substanz auf. Diese Krämpfe dauerten ein bis zwei h. Zugleich mit den klinischen Anfällen nahm der intrakranielle Druck um das drei- bis fünffache zu, um einen Maximaldruck von 20 bis 94 mm Hg nach 20 bis 420 s zu erreichen. Der intrakranielle Druck blieb während 47 s bis 10 min hoch und begann dann allmählich zu fallen, wobei er nach 2 bis 30 min den Wert vor Beginn der Anfälle erreichte, selbst wenn die Anfälle weiterhin andauerten. Die Modifikationen des intrakraniellen Druckes waren unabhängig von den Blutdruckveränderungen. Nachdem der intrakranielle Druck zu den präiktalen Werten wieder zurückgekehrt war, blieb er bis zu sechs h nach Einleiten der Anfälle unverändert.
    Notes: Summary Experiments were carried out in cats to examine the relationship between prolonged convulsions and intracranial pressure. The convulsions were induced by pentylenetetrazole or bicuculline. Blood pressure, intracranial pressure and electroencephalogram were continuously monitored. Generalized tonic-clonic convulsions appeared with typical changes in the electroencephalogram 7–35 s after administration of the epileptogenic drugs. These convulsions persisted for 1–2 h. Concomitant with the clinical convulsions, intracranial pressure increased three- to fivefold, reaching maximal pressures of 20–94 mm Hg after 20–420 s. The intracranial pressure remained high for between 47 s and 10 min, then began to fall gradually, reaching preictal levels after 2–30 min despite the continuation of convulsions. The variations in intracranial pressure were found to be independent of changes in blood pressure. The intracranial pressure, after dropping to preictal values, remained unchanged for up to 6 h after the induction of convulsions.
    Type of Medium: Electronic Resource
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