Effects of a restrictive blood transfusion protocol on acute pediatric burn care: Transfusion threshold in pediatric burns.

Background: Blood transfusion is costly and associated with various medical risks. Studies in critically ill adult and pediatric patients suggest that implementation of more restrictive transfusion protocols based on lower threshold hemoglobin concentrations can be medically and economically advantageous. The purpose of this study was to evaluate the implications of a hemoglobin threshold change in pediatric burn patients.

Inhalation Injury in the Burned Patient.

Inhalation injury causes a heterogeneous cascade of insults that increase morbidity and mortality among the burn population. Despite major advancements in burn care for the past several decades, there remains a significant burden of disease attributable to inhalation injury. For this reason, effort has been devoted to finding new therapeutic approaches to improve outcomes for patients who sustain inhalation injuries.

Propranolol Reduces Cardiac Index But does not Adversely Affect Peripheral Perfusion in Severely Burned Children.

Purpose: The aim of this study was to quantify the effect of propranolol on hemodynamic parameters assessed using the PiCCO system in burned children.

Methods: We analyzed hemodynamic data from patients who were randomized to receive either propranolol (4 mg/kg/day) or placebo (control), which was initiated as a prospective randomized controlled trial. Endpoints were cardiac index (CI), percent predicted heart rate (%HR), mean arterial pressure (MAP), percent predicted stroke volume (%SV), rate pressure product (RPP), cardiac work (CW), systemic vascular resistance index (SVRI), extravascular lung water index (EVLWI), arterial blood gases, events of lactic acidosis, and mortality.

Burn-induced cardiac dysfunction increases length of stay in pediatric burn patients.

The aim of this study was to evaluate cardiac function and clinical outcomes in perioperative pediatric burn patients. Transesophageal echocardiography data were collected on 40 patients from 2004 to 2007. Of the 40 patients who received exams, a complete set of cardiac parameters and outcome variables was obtained in 26 patients.

Intranasal dexmedetomidine premedication is comparable with midazolam in burn children undergoing reconstructive surgery.

Preoperative anxiety and emergence delirium in children continue to be common even with midazolam premedication. Midazolam is unpleasant tasting even with a flavored vehicle and as a result, patient acceptance is sometimes poor. As an alternative, we evaluated dexmedetomidine administered intranasally.

Complications of femoral artery catheterization in pediatric burn patients.

A retrospective analysis of all pediatric patients admitted for acute burn treatment during a 7-year period was conducted to examine patients who underwent femoral artery catheterization and discuss the associated complications and treatment options. The total number of femoral artery catheterizations performed, nature of vascular complications, treatment rendered, and patient outcome were reviewed. Of the 1800 acute burn pediatric patients treated during our study period (1996-2002), 234 patients underwent a total of 745 femoral artery catheterizations.

Effect of progressive mandibular advancement on pharyngeal airway size in anesthetized adults.

Background: General anesthesia in adult humans is associated with narrowing or complete closure of the pharyngeal airway. The purpose of this study was to determine the effect of progressive mandibular advancement on pharyngeal airway size in normal adults during intravenous infusion of propofol for anesthesia.

Methods: Magnetic resonance imaging was performed in nine normal adults during wakefulness and during propofol anesthesia.

Splanchnic oxygen consumption is impaired during severe acute normovolemic anemia in anesthetized humans.

Background: In conscious humans, reduction in hemoglobin concentration to 5 g/dl did not produce inadequate systemic oxygenation. However, systemic measures of inadequate oxygenation may not be sufficiently sensitive to detect inadequate oxygenation in individual organs such as splanchnic organs. The authors tested the hypothesis that acute normovolemic anemia to hemoglobin less than 6.

Percutaneous venovenous perfusion-induced systemic hyperthermia for lung cancer: a phase I safety study.

Background: Veno-venous perfusion-induced systemic hyperthermia (VV-PISH) homogeneously raises core body temperature potentially improving outcomes from metastatic lung cancer.

Methods: Patients (n = 10) with stage IV lung cancer, received VV-PISH (>or= 42 degrees C to View Article and Find Full Text PDF