Factors associated with not meeting the recommendations for micronutrient intake in critically ill children.

Objective: Children admitted to the intensive care unit (ICU) are at risk of not meeting their nutritional requirements. This study aimed to identify factors associated with failure to meet the dietary recommended intake (DRI) of zinc, selenium, cholecalciferol, and thiamine in critically ill children receiving enteral tube feeding during their stay in the ICU.

Methods: We analyzed prospectively 260 cases, corresponding to 206 patients who received enteral tube feeding for a minimum of 3 days up to 10 days during the first 10 d of ICU stay.

Serum Albumin Is an Independent Predictor of Clinical Outcomes in Critically Ill Children.

Objectives: Serum albumin is a strong biomarker of disease severity and prognosis in adult patients. In contrast, its value as predictor of outcome in critically ill children has not been established. We aimed to determine whether admission hypoalbuminemia is associated with outcome in a general pediatric population of critically ill patients, taking into account the inflammatory response, disease severity, and nutritional status of the patient.

Malnutrition may worsen the prognosis of critically ill children with hyperglycemia and hypoglycemia.

Objectives: To determine whether hyperglycemia and hypoglycemia are associated with higher mortality, longer length of intensive care unit (ICU) stay, and fewer ventilator-free days in critically ill children while taking into account the clinical severity and nutrition status.

Patients And Methods: A prospective observational cohort study was conducted on 221 children admitted to the ICU. Blood glucose levels were analyzed in the first 72 hours.

Nebulized 0.5, 2.5 and 5 ml L-epinephrine for post-extubation stridor in children: a prospective, randomized, double-blind clinical trial.

Purpose: Nebulized L-epinephrine has been recommended for the treatment of viral croup. However, the few studies assessing its effect on post-extubation stridor (PES) have shown conflicting results. We compared the efficacy and safety of nebulized L-epinephrine at three different doses for the treatment of PES.

Hypophosphatemia-induced seizure in a child with diabetic ketoacidosis.

We report an unusual case of hypophosphatemia-related seizure in a child with diabetic ketoacidosis (DKA). A 1-year-old type 1 diabetic boy with hyperglycemia, ketoacidosis, and dehydration was admitted to the pediatric intensive care unit. After having received fluid replacement using isotonic solution with added potassium and continuous intravenous insulin administration according to the protocol for DKA, the patient was conscious, awake, and fed with breast milk.

The product of platelet and neutrophil counts (PN product) at presentation as a predictor of outcome in children with meningococcal disease.

Background: Despite improvement in the treatment of Neisseria meningitidis infection, meningococcal diseases (MD) are still an important cause of morbidity and mortality around the world. This study assessed the performance of the product of platelet and neutrophil counts (PN product) at the time of presentation to hospital as a predictor of outcome in children with MD.

Methods: Retrospective evaluation of children with clinical MD admitted to two paediatric intensive care units in Brazil.

Enteral nutrition in critically ill children: are prescription and delivery according to their energy requirements?

Background: The purpose of this study was to compare the differences between prescribed and delivered energy among critically ill children and to identify the factors that impede the optimal delivery of enteral nutrition in the first 5 days of nutrition support.

Methods: In a prospective cohort study, we evaluated 55 critically ill children aged 8.2 +/- 11.

Procedural sedation for insertion of central venous catheters in children: comparison of midazolam/fentanyl with midazolam/ketamine.

Background: There is a lack of studies evaluating procedural sedation for insertion of central venous catheters (CVC) in pediatric patients in emergency departments or pediatric intensive care units (PICU). This study was designed to evaluate whether there is a difference in the total sedation time for CVC insertion in nonintubated children receiving two sedation regimens.

Methods: Patients were prospectively randomized to receive either midazolam/fentanyl (M/F) or midazolam/ketamine (M/K) i.

Bedside transpyloric tube placement in the pediatric intensive care unit: a modified insufflation air technique.

Objective: To test air insufflation as an adjunct to placement of enteral feeding tubes and the effectiveness of using a smaller insufflation volume in pediatric patients.

Design And Setting: A randomized, controlled study in a pediatric intensive care unit in two tertiary hospitals.

Patients: A total of 78 children with indication for transpyloric tube feeding were studied.