Chloral hydrate intoxication in a 3-month-old child: avoidance of hemodialysis by an immediate determination of trichloroethanol.

Background: Chloral hydrate is used worldwide as a first-line agent for procedural sedation in paediatric patients undergoing painless diagnostic investigations. Chloral hydrate overdoses in children and adults have been reported to cause various toxicities, including central nervous system, respiratory and cardiac depression with sometimes fatal outcome.

Patient And Methods: A 3-month-old girl was admitted after an unintentional administration of a 10-fold dose of chloral hydrate (667 mg/kg).

Management of blunt tracheal trauma in children: a case series and review of the literature.

Blunt tracheal trauma seldom develops in children because of their anatomy and the mobility of the cartilage. It has the potential to be overlooked, either because of the severity of concomitant injuries or because of the unfamiliarity of paediatricians with this type of injury. However, tracheal injury might be lethal due to airway compromise.

Posttraumatic cholothorax in a child: case report and review of the literature.

Objective: Thoracobiliary fistula, subsequent to a combined thoracic and hepatic blunt trauma, is a rare complication, which calls for a high index of suspicion during diagnostic workup. Due to its uncommon nature, especially in children, and hence the paucity of reports in literature, no consensus has been reached on its optimal management.

Patients And Methods: We report on a 4-yr-old girl, who developed a cholothorax after a blunt thoracoabdominal trauma.

Oxygenation index, an indicator of optimal distending pressure during high-frequency oscillatory ventilation?

Objective: To test the hypothesis that, during high-frequency oscillatory ventilation (HFOV) of pigs with acute lung injury, the oxygenation index (OI = Paw*FIO(2)*100/PaO(2)) is minimal at the lowest continuous distending pressure (Paw), where the physiological shunt fraction is below 0.1 (Paw(optimal)).

Design And Setting: Prospective, observational study in a university research laboratory.

Attenuation of pressure swings along the endotracheal tube is indicative of optimal distending pressure during high-frequency oscillatory ventilation in a model of acute lung injury.

We tested the hypothesis that during high-frequency oscillatory ventilation, the oscillatory pressure ratio (OPR) is minimal at the optimal mean airway pressure (Paw). OPR is defined as the ratio of pressure swings at the distal end and the proximal opening of the endotracheal tube. Optimal Paw was assumed to be the lowest Paw at which the physiological shunt fraction was below 0.