Evaluating the Use of Octreotide for Acquired Chylothorax in Pediatric Critically Ill Patients Following Cardiac Surgery.

Objectives: To evaluate the impact of octreotide on time to resolution of chylothorax compared with conventional therapy. Secondary outcomes include the following: time to reduction of chest tube output by 20%, additional surgeries for chylothorax, hospital length of stay, in-hospital mortality, and adverse drug reactions.

Methods: We retrospectively evaluated the efficacy of octreotide vs conventional therapy for treatment postoperative chylothorax in pediatric patients in the cardiac ICU following surgery for congenital heart disease between October 2008 and June 2017.

Head lice and the use of spinosad.

Background: Head lice infestations are responsible for social and economic distress. Despite a reported increase in resistance, permethrin 1% is still the first-line treatment of head lice. Alternative topical pediculicidal agents include malathion and benzyl alcohol, but resistance is of growing concern.

A trial of methadone tapering schedules in pediatric intensive care unit patients exposed to prolonged sedative infusions.

Objectives: To compare the efficacy of a low-dose methadone tapering schedule to a high-dose methadone tapering schedule in pediatric intensive care unit patients exposed to infusions of fentanyl, with or without infusions of midazolam, for ≥ 5 days.

Design: Prospective, double-blind, randomized trial.

Setting: Pediatric intensive care unit in a tertiary care children's hospital.

Principles of drug transfer into breast milk and drug disposition in the nursing infant.

There are numerous factors to consider when assessing the safety of drugs in lactating women. Drug properties facilitating transfer into milk as well as the pharmacokinetic properties of the drug in the mother and infant must be evaluated. Drug properties which promote low milk concentrations are: large volume of distribution, high protein binding, low lipid solubility, ionization at physiologic pH and large molecular weight.