Use of an armoured endotracheal tube in a toddler with mediastinal mass.

Anterior mediastinal mass presents an airway challenge due to its relative size in a paediatric chest and its invasion and compression of the surrounding structures. We present a case of a toddler with airway obstruction secondary to an anterior mediastinal mass. We describe how the use of an armoured endotracheal tube helped with ventilation while waiting for steroids and chemotherapy to reduce the tumour size and compression.

Profiling gut microbiota and bile acid metabolism in critically ill children.

Broad-spectrum antimicrobial use during the treatment of critical illness influences gastrointestinal fermentation endpoints, host immune response and metabolic activity including the conversion of primary to secondary bile acids. We previously observed reduced fermentation capacity in the faecal microbiota of critically ill children upon hospital admission. Here, we further explore the timecourse of the relationship between the microbiome and bile acid profile in faecal samples collected from critically ill children.

Impact of infectious diseases consultation on the management of Staphylococcus aureus bacteraemia in children.

Objectives: Infectious diseases consultation (IDC) in adults with Staphylococcus aureus bacteraemia (SAB) has been shown to improve management and outcome. The aim of this study was to evaluate the impact of IDC on the management of SAB in children.

Study Design: Observational cohort study of children with SAB.

Outpatient respiratory management of the child with severe neurological impairment.

Most paediatricians will have faced the challenge of managing respiratory problems in the child with severe neurological impairment. These children are under-represented in clinical trials, and data is therefore often extrapolated from other groups, for example children with cystic fibrosis. This means that robust evidence for respiratory management in children with severe neurological impairment is often lacking.

The neuroendocrine stress response and severity of acute respiratory syncytial virus bronchiolitis in infancy.

Objective: Neuroendocrine hormones have profound effects on the immune system. The immune response is a major factor in the pathogenesis of acute respiratory syncytial virus (RSV) infection. We hypothesised that there is a relationship between the neuroendocrine response in acute RSV infection, the severity of illness, and the degree of lymphopenia.

Respiratory viruses in the intensive care unit.

Respiratory viruses cause a number of clinical 'syndromes' in the intensive care unit with different viruses being able to produce similar clinical pictures. Our main presenting problems are upper airway (e.g.