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Corticosteroids in Pediatric Septic Shock: A Narrative Review.
J Pers Med
December 2024
Neonatal and Pediatric Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy.
A controversial aspect of pediatric septic shock management is corticosteroid therapy. Current guidelines do not recommend its use in forms responsive to fluids and inotropes but leave the decision to physicians in forms refractory to the first steps of therapy. Review of literature from January 2013 to December 2023 from online libraries Pubmed, Medline, Cochrane Library, and Scopus.
View Article and Find Full Text PDFTriglycerides and Sodium: Unmasking Pseudohyponatremia in a Clinical Case.
Cureus
November 2024
Acute Medicine, Leicester Royal Infirmary, Leicester, GBR.
Sodium is one of the most important minerals in human blood. Sodium disorders, either in the form of hypernatremia or hyponatremia, have detrimental effects on the body; therefore, they warrant urgent attention. Hyponatremia occurs in various clinical scenarios; it can be further categorized as true hyponatremia and pseudohyponatremia.
View Article and Find Full Text PDFImpact on fluid balance of an optimized restrictive strategy targeting non-resuscitative fluids in intensive care patients with septic shock: a single-blind, multicenter, randomized, controlled, pilot study.
Crit Care
December 2024
Division of Anesthesia, Critical Care, Pain and Emergency Medicine, UR‑UM103 IMAGINE, University of Montpellier, Nimes University Hospital, Nîmes, France.
Background: In septic shock, the classic fluid resuscitation strategy can lead to a potentially harmful positive fluid balance. This multicenter, randomized, single-blind, parallel, controlled pilot study assessed the effectiveness of a restrictive fluid strategy aiming to limit daily volume.
Methods: Patients 18-85 years' old admitted to the ICU department of three French hospitals were eligible for inclusion if they had septic shock and were in the first 24 h of vasopressor infusion.
A nested case-control study of adverse outcomes in children with diabetic ketoacidosis.
J Clin Endocrinol Metab
December 2024
Division of Pediatric Endocrinology, Department of Pediatrics, UT Southwestern Medical Center, Dallas TX.
Background: Adverse Outcomes (death or ICU stays longer than 48h) in children with diabetic ketoacidosis (DKA) or hyperglycemic-hyperosmolar syndrome (HHS) can be predicted by a composite risk score based on severity of hyperglycemia and acidosis, and presence of type 2 diabetes. Because most high-risk patients nevertheless do not experience an Adverse Outcome, we tried to identify differences in management or other clinical characteristics that influenced outcomes.
Methods: In a previously defined group of 4565 admissions for DKA-HHS in 2010-2023, 109 had Adverse Outcomes.
The natural history of untreated X-linked nephrogenic diabetes insipidus with mutation in the vasopressin V2 receptor gene.
CEN Case Rep
December 2024
Department of Woman, Child and of General and Specialized Surgery, Università degli studi della Campania "Luigi Vanvitelli", Via Luigi De Crecchio 2, 80138, Naples, Italy.
Nephrogenic diabetes insipidus (NDI) results from the kidneys' inability to concentrate urine. We describe a 6-month-old male with a history of poor weight gain who presented with an incidental finding of hypernatremia (155 mEq/L) during an episode of acute gastroenteritis. The arginine vasopressin (AVP) test, along with molecular analysis revealing the M272R mutation in the AVP receptor 2 (AVPR2) gene, confirmed the diagnosis of congenital NDI.
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