[Flail chest in pediatric patient. Case report].

Flail chest is defined by fracture of 3 or more adjacent ribs, at 2 or more sites, with paradoxical movement of the affected chest. It occurs in 2 to 4 % of blunt chest trauma, with a mortality of 10 to 15 %. Treatment is conservative, using analgesia and positive pressure ventilation, or surgical osteosynthesis of rib fractures.

[National Nursing Consensus on management of severe traumatic brain injury in children].

The nursing professional who treats critically ill children with cerebral injury is a key element within the pediatric intensive care team, since, through exhaustive assessment, plans nursing care in an integral manner aimed at the child and the family, and plays an essential role in the care of patients mainly at the hospital level (as well as at home). Therefore, the role played by nursing in the care of children with severe brain trauma is crucial. This guide offers nursing recommendations on neurocritical care, focusing on a systemic view based on nursing diagnoses according to the North American Nursing Diagnosis Association.

[Escorpionism in pediatric intensive care patients. Case series].

Scorpionism is a public health problem with an increasing incidence in Argentina. The poison contains several neurotoxins capable of generating an "autonomic storm" responsible for the clinical manifestations. The cardiovascular and respiratory systems are the most affected ones and their degree of commitment will determine morbidity and mortality.

Sedation and analgesia in patients on mechanical ventilation in pediatric intensive care units in Argentina.

Introduction: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV).

Objective: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina.

Brain death and organ donation in Argentine pediatric intensive care units. A multicenter study.

Brain death (BD) is a condition determined by the complete and irreversible absence of brain functions. Maintenance of vital functions creates an opportunity for organ donation. A retrospective study was carried out in 7 pediatric intensive care units of Argentina (from 1/1/2013 to 9/30/2016) to determine the incidence of clinical and certified BD, and the proportion of effective transplantations.

[Update on leukoreduction therapies as alternatives for the treatment of severe pertussis].

Pertussis is a contagious disease that in patients under 1 year of age may evolve to a highly lethal course characterized by hypoxemia and refractory pulmonary hypertension, being this responsible for cardiovascular collapse. Pulmonary hypertension occurs by direct action of bacteria and its toxins, responsible for the vascular tone alteration associated with hyperviscosity syndrome and arteriolar thrombosis due to hyperleukocytosis. Since 2004, leucodepletion has been proposed as a treatment option; there are currently 18 publications on leucodepletion in patients with severe Pertussis, with a total of 288 patients, 68 cytoreduction procedures and a mortality rate of 28% in those exposed to the mentioned treatment.

[Extramedullary relapse of acute lymphoblastic leukemia: report of a case].

The superior vena cava syndrome (SVCS) is considered an emergency and requires immediate treatment; therefore, the etiologic diagnosis is essential before deciding on its implementation. The management of SVCS consists on the relief of symptoms and treatment of the underlying disease, aiming to restore the blood flow. We present a 5 years old boy with a history of B-cell ALL.

Severe Staphylococcus aureus infection in three pediatric intensive care units: analysis of cases of necrotizing pneumonia.

Staphylococcus aureus frequently affects human beings. Among clinical manifestations, necrotizing pneumonia is associated with a high mortality rate. Our objective is to describe the progress of severe Staphylococcus aureus infections in three intensive care units and analyze cases ofnecrotizing pneumonia in the period ranging from January 2011 to March 2013.

[Right postpneumonectomy syndrome: case report].

Postpneumonectomy syndrome is a rare entity in children. We report a case secondary to pneumonectomy performed due to an intrathoracic tumor. A 4-year-old boy with a history of right pneumonectomy and progressive respiratory distress, with extrinsic airway obstruction due to displaced mediastinal structures.

[Severe pertussis, progression and exchange transfusion as an alternative treatment. Case reports].

Pertussis is a contagious disease that may develop a serious clinical picture by hypoxemia and pulmonary hypertension refractory to treatment. The syndrome of hyperviscosity and arteriolar thrombosis is responsible for the cardiocirculatory collapse. Our objective is to describe the evolution of a series of patients with severe pertussis, some of whom received exchange transfusion (ET) as an alternative treatment.

[Effectiveness analysis of high-frequency oscillatory ventilation in pediatrics patients with acute respiratory failure in a tertiary hospital].

Introduction. High frequency oscillatory ventilation (HFOV) is a rescue therapy for hypoxemic patients who deteriorate in conventional mechanical ventilation and/or for the air-leak syndrome treatment. A recent meta analysis showed that HFOV might have reduced mortality in pediatric and adult patients compared with conventional ventilation.

[Pain prevention in term neonates: randomized trial for three methods].

Introduction: Every newborn infant is screened for hypothyroidism and phenylketonuria by blood sampling, during the first week of life, but there is not a simple and efficient method to reduce pain during the procedure.

Objectives: Prospective randomised trial, to assess if the administration of oral glucose, paracetamol or EMLA, given individually, can reduce the pain caused in newborns by heel prick, in an outpatient setting.

Methods: Double-blind study in which seventy six healthy newborns at term were randomly assigned to receive placebo, oral glucose, EMLA in the heel, or oral paracetamol.