Data regarding the use of fluoroquinolones in critically ill children are scarce. We present our experience regarding the use of ciprofloxacin in this specific patient population. We prospectively identified all paediatric patients who received ciprofloxacin treatment in the intensive care unit of the tertiary care P. & A. Kyriakou Children's Hospital during a three year period (2005 to 2008). Eighteen paediatric patients (mean age 23 months, 12 females) who received intravenous ciprofloxacin were identified. Various underlying diseases, including malignancy and immunodeficiency, were observed. None of the evaluated patients had cystic fibrosis. Fourteen patients had bacteraemia (mainly caused from Gram-negative pathogens), one had Stenotrophomonas maltophilia pneumonia, while no pathogen was identified in three patients. The latter patients received ciprofloxacin due to the severity of their clinical manifestations. All patients with microbiologically documented infections recovered. Three deaths attributed to the underlying diseases were noted. Within a 10-day follow-up, two cases of diarrhoea, one case of vomiting and one case of reversible supraventricular tachycardia were noted. No case of QT prolongation was noted. The short-term follow-up hampered any assessment of joint and cartilage toxicity, potentially associated with ciprofloxacin treatment. Our study suggests that ciprofloxacin may be a useful option for critically ill children without cystic fibrosis. Even though firm conclusions regarding the safety profile of ciprofloxacin in critically ill children could not be drawn, our study provides useful information regarding short-term adverse events associated with ciprofloxacin.
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http://dx.doi.org/10.1177/0310057X1103900416 | DOI Listing |
Curr Opin Clin Nutr Metab Care
December 2024
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital.
Purpose Of Review: The human circadian system regulates several physiological processes, including metabolism, which becomes significantly disrupted during critical illness. The common use of 24-h continuous nutrition support feeding in the intensive care unit (ICU) may further exacerbate these disruptions; this review evaluates recent evidence comparing continuous and intermittent feeding schedules in critically ill adults.
Recent Findings: Research comparing different feeding schedules in critically ill adults remains limited.
Australas J Ageing
January 2025
Centre for Population Health, Western Sydney Local Health District, Parramatta, New South Wales, Australia.
Objectives: Acute respiratory illnesses have a disproportionate impact on older people, and especially those living in residential aged care facilities where transmission risks are heightened. Additionally, staff in these facilities have been working under challenging conditions, often ill-equipped in terms of both training and resources to successfully manage the outbreaks of these illnesses. This paper examines the actions of an Australian public health unit to improve influenza outbreak management in residential aged care facilities and critiques the outcomes through a contemporary lens.
View Article and Find Full Text PDFTruth-telling for terminally ill patients is a challenging ethical and social issue for Chinese health care professionals. However, despite the existence of ethical and moral standards for nurses, they frequently encounter moral dilemmas when making decisions about truth-telling to patients with end-stage diseases in China. This article aims to provide ethical strategies for clinical nurses in China regarding truth-telling decisions for terminally ill patients on the basis of their individual autonomy.
View Article and Find Full Text PDFKidney360
January 2025
Department of Pediatrics, Division of Nephrology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Background: Acute kidney disease (AKD) includes abnormalities of kidney function present for <90 days. Acute kidney injury (AKI) is defined as a subset of AKD, with onset within seven days. There is scant data on the rates of AKD in children and its association with outcomes.
View Article and Find Full Text PDFElife
January 2025
Department of Neurosurgery, Washington University School of Medicine, Springfield, United States.
Background: Subarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia. Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients. However, the effects of taVNS on cardiovascular dynamics in critically ill patients, like those with SAH, have not yet been investigated.
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