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Digitale Medien

Dexamethasone therapy and endogenous cortisol production in severe pediatric head injury (1988)

Fanconi, S. ; Klöti, J. ; Meuli, M. ; [weitere]

Springer

Intensive care medicine 14 (1988), S. 163-166

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ISSN: 1432-1238

Schlagwort(e): Dexamethasone ; Cortisol ; Head injury ; Pediatric

Quelle: Springer Online Journal Archives 1860-2000

Thema: Medizin

Notizen: Abstract A prospective randomised study was performed on 25 children aged 1.4 to 15.8 years with severe head injury (Glasgow Coma Scale⪕7) to determine the clinical effectiveness and the impact on endogenous cortisol production of high-dose steroid therapy. Thirteen patients (group 1) received dexamethasone 1 mg/kg/day during the first 3 days and 12 (group 2) not. All patients were treated with a standardized regimen. Urinary free cortisol was measured by radioimmunoassay, and the clinical data were recorded at hourly intervals. Outcome was assessed 6 months later using the Glasgow Outcome Scale. We found a higher frequency of bacterial pneumonias in the dexamethasone-treated patients (7/13 versus 2/12). Group 1 showed a suppression of endogenous cortisol production from day 1 to day 6. In group 2, menu free cortisol was up to 5-fold higher than under basal conditions. The results in group 2 showed taht the endogenous steroid production reacts adequately to the stress of severe head injury. It probably is sufficient to elicit maximum glucocorticoid effects. There was no other statistically significant difference in the clinical and laboratory data between the two groups. We conclude that dexamethasone in high doses suppresses endogenous cortisol production up to 6 days and may increase the risk of bacterial infection without affecting the outcome or the clinical and laboratory data.

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1007/BF00257471

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Digitale Medien

Pulse oximetry for hypoxemia: a warning to users and manufacturers (1989)

Fanconi, S.

Springer

Intensive care medicine 15 (1989), S. 540-542

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ISSN: 1432-1238

Schlagwort(e): Pulse oximetry ; Hypoxemia

Quelle: Springer Online Journal Archives 1860-2000

Thema: Medizin

Notizen: Abstract Pulse oximetry represents a major advance in patient monitoring, but measurement below 70 to 80% saturation has important limitations. Several authors have tested pulse oximetry at low saturations with conflicting results. A review of these data indicates that every patient with a pulse oximeter value below 75 to 80% SaO2 should have one or more invasive measurements of the arterial SaO2 in order to avoid undetected severe hypoxemia.

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1007/BF00273571

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Digitale Medien

Isolated (biotin-resistant) 3-methylcrotonyl-CoA carboxylase deficiency presenting at age 20 months with sopor, hypoglycaemia and ketoacidosis (1987)

Gitzelmann, R. ; Steinmann, B. ; Niederwieser, A. ; [weitere]

Springer

Journal of inherited metabolic disease 10 (1987), S. 290-292

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ISSN: 1573-2665

Quelle: Springer Online Journal Archives 1860-2000

Thema: Medizin

Materialart: Digitale Medien

URL: http://dx.doi.org/10.1007/BF01811429

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