Opioid-induced toxic leukoencephalopathy: A case report and review of the literature.

Importance: Reports of toxic leukoencephalopathy (TLE) due to opioids have been extensively documented within the adult literature. There is a paucity of literature with respect to the incidence, complications, and outcomes of TLE in the pediatric population.

Objective: To describe a rare complication of opioid ingestion in the pediatric population and serve as the first large review of published cases of opioid-induced leukoencephalopathy.

Use of Etomidate for Rapid Sequence Intubation (RSI) in Pediatric Trauma Patients: An Exploratory National Survey.

, To survey the pediatric trauma programs to ascertain if and how etomidate is being used for rapid sequence intubation (RSI) in pediatric trauma patients. , A 25 question survey was created using REDCaps. A link to the survey was emailed to each of the pediatric and adult trauma programs that care for pediatric patients.

A Curriculum to Improve Residents' End-of-Life Communication and Pain Management Skills During Pediatrics Intensive Care Rotation: Pilot Study.

Background: Research suggests pediatrics practitioners lack confidence and skills in the end-of-life (EOL) care.

Objective: This pilot study explored the impact of a curriculum designed to prepare future pediatricians to manage pain and provide comfort for children and infants with life-threatening conditions and to be more confident and competent in their EOL discussions with families.

Methods: Participants included 8 postgraduate year (PGY)-2 residents in the study group and 9 PGY-3 residents in a control group.

First responder performance in pediatric trauma: a comparison with an adult cohort.

Introduction: Is the prehospital care of injured children comparable with adult standards? This question has been asked repeatedly by many clinicians, yet there are no definite answers.

Objective: To evaluate the prehospital care provided by first responders to pediatric patients (<12 yrs of age) with head injury compared with the adult group (>12 yrs of age) to determine whether the emergency medical services providers are able to adequately assess the children and provide emergency services comparable with adult standards.

Patients And Methods: A retrospective 4-yr review of pediatric (n = 102) and adult (n = 99) patients with head injury and Glasgow coma scale score <15 who were treated at a level 1 trauma center.

Partial-exchange blood transfusion: an effective method for preventing mortality in a child with propofol infusion syndrome.

Here we describe a case of propofol-related infusion syndrome (PRIS) in a child with malignant refractory status epilepticus treated with partial-exchange blood transfusion (PEBT), an innovative method of resuscitation that has the potential to reduce the mortality rate associated with this syndrome. Our patient is a 4-year-old boy with malignant status epilepticus associated with bacterial meningitis. Propofol was used because of persistent seizure activity refractory to adequate doses of phenytoin, phenobarbital, levetiracetam, and midazolam infusion at 0.

Drotrecogin alfa (activated) in an infant with gram-negative septic shock.

The authors observed the effect of drotrecogin alfa (activated) in a case of pediatric severe sepsis. A 4-month-old male infant with Serratia marcescens septic shock, multiple organ dysfunction syndrome (MODS), and consumptive coagulopathy was admitted. The safety and efficacy of drotrecogin alfa (activated) has not yet been established for patients younger than 18 years of age.

Inhaled nitric oxide: another weapon in our armamentarium in the battle against acute hypoxic respiratory failure in preterm infants.

Acute hypoxic respiratory failure (AHRF) remains a significant cause of death in intensive care units. With the realization that pathophysiologic abnormalities in AHRF involve surfactant abnormalities as well as inflammatory and vascular changes, it is not surprising that nitric oxide (NO) has been investigated as an adjunct to the multiple ventilatory strategies adopted in the management of this disorder. Since the enthusiastic reports of Roussaint in 1993 showing improved survival with inhaled NO in the management of AHRF, several well-designed studies have been published, all designed to investigate the utility of NO in neonatal, pediatric and adult patients.

Congenital methemoglobinemia: a rare cause of cyanosis in the newborn--a case report.

Cyanosis is a physical finding that can occur at any age but presents the greatest challenge when it occurs in the newborn. The cause is multiple, and it usually represents an ominous sign, especially when it occurs in association with neonatal sepsis, cyanotic congenital heart disease, and airway abnormalities. Cyanosis caused by abnormal forms of hemoglobin can also be life-threatening, and early recognition is mandatory to prevent unnecessary investigations and delay in management.