Sedation and subglottic stenosis in critically ill children
Journal Title: Jornal de Pediatria - Year 2017, Vol 93, Issue 4
Abstract
As mortality rates have decreased over the past few decades, the focus of contemporary pediatric critical care has shifted toward minimizing long-term morbidity. Children requiring endotracheal intubation and mechanical ventilation are at risk for a number of lasting sequelae, including chronic respiratory failure, neuropathy/myopathy, and cognitive impairment.1 Risk factors for individual complications have been described, and actions to avoid these risk factors should be considered. However, avoiding one action invariably causes a reaction that may confer its own adverse effects. For example, a dry lung strategy shortens the duration of mechanical ventilation in the acute respiratory distress syndrome (ARDS), but may worsen long-term neurologic status.2,3 A lung-protective strategy may reduce ventilator-associated lung injury and the risk of chronic respiratory failure, but the resultant acidosis and elevated intrathoracic pressures can be poorly tolerated in children with fluid-refractory shock, pulmonary hypertension, and/or intracranial hypertension.4 When faced with multiple therapeutic options, pediatric intensivists must be cognizant of the risks and benefits of all possible paths.
Authors and Affiliations
Alexandre Rotta
Keywords
Related Articles
- EP ID EP503555
- DOI 10.1016/j.jped.2017.03.001
- Views 50
- Downloads 0
Effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum
Objective To evaluate the effect of maternal supplementation with vitamin E on the concentration of α-tocopherol in colostrum and its supply to the newborn. Method This randomized clinical trial enrolled 99 healthy adul...
Children's Sleep Habits Questionnaire – Infant Version
Objectives This study proposed a version of the Children's Sleep Habits Questionnaire for infants under 12 months (CSHQ-I). Methods The sample was comprised of 299 infants, aged between 2 weeks and 12 months. Results E...
Intimate partner violence and breastfeeding practices: a systematic review of observational studies
Objective To review the association between intimate partner violence and breastfeeding practices in the literature. Data sources The search was carried out in five databases, including MEDLINE, LILACS, SCOPUS, PsycoINF...
A higher number of school meals is associated with a less-processed diet
Objective To compare the participation of food groups – fresh and minimally processed, processed, and ultra-processed – in the diet of students (n=1357) from Belo Horizonte, MG, Brazil, in accordance with the number of s...
The protective arm of the renin–angiotensin system may counteract the intense inflammatory process in fetuses with posterior urethral valves
Objective Posterior urethral valve is the most common lower urinary tract obstruction in male children. A high percentage of patients with posterior urethral valve evolve to end-stage renal disease. Previous studies show...