Smart respiratory monitoring: clinical development and validation of the IPI™ (Integrated Pulmonary Index) algorithm.

Continuous electronic monitoring of patient respiratory status frequently includes PetCO (end tidal CO), RR (respiration rate), SpO (arterial oxygen saturation), and PR (pulse rate). Interpreting and integrating these vital signs as numbers or waveforms is routinely done by anesthesiologists and intensivists but is challenging for clinicians in low acuity areas such as medical wards, where continuous electronic respiratory monitoring is becoming more common place. We describe a heuristic algorithm that simplifies the interpretation of these four parameters in assessing a patient's respiratory status, the Integrated Pulmonary Index (IPI).

Acute obtundation in a 9-month-old patient: ethanol ingestion.

Alcohol ingestion in the pediatric patient can be life threatening. Younger patients consume larger volumes per body weight with accidental ingestions, and children have more serious adverse effects at lower blood alcohol levels. Complications of alcohol poisoning can include hypothermia, hypoglycemia, seizures, coma, and death.

Disseminated mucormycosis in an adolescent with newly diagnosed diabetes mellitus.

We report a 16-year-old, previously healthy female who presented with disseminated mucormycosis leading to multiorgan failure and death with newly diagnosed type 1 diabetes mellitus and ketoacidosis. We review previous reported cases of mucormycosis in children with diabetes to demonstrate that this uncommon invasive infection may cause significant morbidity and mortality in this population.

Developing a standard method for apnea testing in the determination of brain death for patients on venoarterial extracorporeal membrane oxygenation: a pediatric case series.

Objective: The revised guidelines for the determination of brain death in infants and children stress that apnea testing is an integral component in determining brain death based on clinical criteria. Unfortunately, these guidelines provide no process for apnea testing during the determination of brain death in patients supported on venoarterial extracorporeal membrane oxygenation. We review three pediatric patients supported on venoarterial extracorporeal membrane oxygenation who underwent apnea testing during their brain death evaluation.