Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
1.
Crit Care Med ; 45(4): 584-590, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28079605

RESUMO

OBJECTIVES: To determine prevalence of delirium in critically ill children and explore associated risk factors. DESIGN: Multi-institutional point prevalence study. SETTING: Twenty-five pediatric critical care units in the United States, the Netherlands, New Zealand, Australia, and Saudi Arabia. PATIENTS: All children admitted to the pediatric critical care units on designated study days (n = 994). INTERVENTION: Children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the bedside nurse. Demographic and treatment-related variables were collected. MEASUREMENTS AND MAIN RESULTS: Primary study outcome measure was prevalence of delirium. In 159 children, a final determination of mental status could not be ascertained. Of the 835 remaining subjects, 25% screened positive for delirium, 13% were classified as comatose, and 62% were delirium-free and coma-free. Delirium prevalence rates varied significantly with reason for ICU admission, with highest delirium rates found in children admitted with an infectious or inflammatory disorder. For children who were in the PICU for 6 or more days, delirium prevalence rate was 38%. In a multivariate model, risk factors independently associated with development of delirium included age less than 2 years, mechanical ventilation, benzodiazepines, narcotics, use of physical restraints, and exposure to vasopressors and antiepileptics. CONCLUSIONS: Delirium is a prevalent complication of critical illness in children, with identifiable risk factors. Further multi-institutional, longitudinal studies are required to investigate effect of delirium on long-term outcomes and possible preventive and treatment measures. Universal delirium screening is practical and can be implemented in pediatric critical care units.


Assuntos
Estado Terminal/psicologia , Delírio/epidemiologia , Adolescente , Austrália/epidemiologia , Criança , Pré-Escolar , Coma/epidemiologia , Delírio/diagnóstico , Feminino , Humanos , Lactente , Recém-Nascido , Unidades de Terapia Intensiva Pediátrica/estatística & dados numéricos , Masculino , Países Baixos/epidemiologia , Nova Zelândia/epidemiologia , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Estados Unidos/epidemiologia
2.
J Pediatr Surg ; 55(4): 752-755, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31138449

RESUMO

BACKGROUND: Pulmonary hydatid disease remains an important healthcare problem. Conservative operative interventions including cystotomy or cystotomy with capitonnage are the two commonly used techniques. However, there is no scientific consensus over selection of these operative interventions. AIM: The aim of this study is to compare these two methods: capitonnage and uncapitonnage in the surgery of childhood pulmonary hydatid cyst in regard to the postoperative period. METHODS: This is a retrospective analysis of 136 patients operated for pulmonary hydatid disease between January 2010 and July 2017 according to two techniques. Group A was cystotomy with capitonnage (n = 76), and group B was cystotomy alone (n = 60). We compared the postoperative outcomes. RESULTS: Our data showed pneumothorax(PNO) and emphysema were seen in 30% of Group B and only in 13.2% in Group A, and the persistence of residual cavity in 23.3% in Group B and 7.9% in Group A (p = 0.014). We have not seen any case of recurrence with capitonnage. CONCLUSION: We conclude that capitonnage appears to prevent PNO and emphysema formation and a remaining residual cavity in the long term with a significant difference. And it prevents prolonged postoperative air leak and hospitalization with a slightly nonsignificant difference. It is difficult to say with absolute certainty that the noncapitonnage group is inferior to the capitonnage group, since several factors can influence the evolution. TYPE OF STUDY: Clinical research article Level of evidence III.


Assuntos
Equinococose Pulmonar/cirurgia , Complicações Pós-Operatórias/etiologia , Técnicas de Sutura , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Tempo de Internação , Masculino , Pneumotórax/etiologia , Período Pós-Operatório , Enfisema Pulmonar/etiologia , Recidiva , Estudos Retrospectivos , Técnicas de Sutura/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA