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Kendra Jackson and Rebecca Raffler While we’ve gotten to snack on a Morsel on this subject before , new guidelines and research surrounding DKA and cerebral edema have come to light since the first go ‘round! Cerebral edema is the most feared emergent complication of pediatric diabetic ketoacidosis. Pediatr Diabetes.
She appears pale and dehydrated , and her level of alertness fluctuates. Pay specific attention to fluid status, looking for evidence of dehydration. Manage hydration Children may be dehydrated or present with signs of fluid overload. 4-year-old Stephanie presents with vomiting, diarrhoea, and lethargy.
The factorial design chosen by Dr Maitland and her research group means that several comparisons in transfusion practice could be carried out at the same time. What were the research questions? Does the study address a clearly focused research question? N Engl J Med. 2019;381(5):407-419. Was blinding achieved?
Literature Review: There is abundant literature on pediatric AGE but sparse research on AGE in adults. Therefore, many recommendations are extrapolated from the pediatric literature. Laboratory Testing and Imaging: Dehydration is the biggest contributor to mortality, especially in the very young and elderly.
If the fractional excretion of sodium is <1%, you agree with your consultant that you will also ask the nurses to account for the replacement of 5% dehydration (900ml) over 48h (≈ 19ml/h). Given the present urine output of 0.3ml/kg/hr and no dehydration replacement, you estimate she will receive ~1mmol/kg/day of sodium. Pediatrics.
My special guest podcaster, Emily Groopman, is an actual Pediatric Geneticist in training and we hope that you will find this episode useful. Pediatr Rev. Pediatrics. Transcript Note: This transcript was partially completed with the use of the Descript AI Welcome to PEM Currents, the Pediatric Emergency Medicine Podcast.
Diarrhea is one of the most common complaints in the pediatric emergency department, especially in the summer and early fall. Sure this may cause blood in stool, but consider Hemolytic Uremic Syndrome when evaluating pediatric patients with Bloody Diarrhea. Clin Pediatr (Phila). Protect the Kidneys! 2010 May;49(5):418-21.
2] Since this data was published the APLS guidelines have altered to reflect these results and the need for more research in this area and now recommend the 10ml/kg boluses as above compared to the previous recommendation of 20ml/kg. saline), however more research is needed in this area. [4] Which type of fluid to use?
This episode reviews risk factors for apnea and severe bronchiolitis; discusses treatments/therapies and provides evidence-based recommendations for the management of pediatric patients with bronchiolitis. 35-37 High Flow Nasal Cannula (HFNC) Several small pediatric ICU studies show a benefit in severe cases. Further study needed.
⇒ You have a stable child who just needs fluids, but no laboratory tests ⇒ You’ve tried PO hydration, to no avail, despite anti-emetics ⇒ You’re poking the stable, but dehydrated child repeatedly without success What now? Recombinant human hyaluronidase-enabled subcutaneous pediatric rehydration. Pediatrics. Pediatrics.
Jeff: This DEA designation limits the ability to do research and obtain federal funding for such research. Synthetics were initially developed in the 1980s largely for research purposes. Jeff: The hyperemetic phase lasts 24-48 hours and can lead to dehydration, electrolyte abnormalities, and weight loss.
Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis. You confirm her bedside ketones to be 6 and have secured a cannula (intravenous) ready to reverse her dehydration – but what fluids should you use and at what rate?
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. Reviews and opinion articles Point-of-care ultrasound in pediatric nephrology. Pediatr Nephrol. JAMA Pediatr. Eur J Pediatr. Eur J Pediatr.
We suggest this list can help you discover relevant or interesting articles for your local journal club or allow you to keep a finger on the pulse of paediatric research. This retrospective cohort study in JAMA Pediatrics looked at the impact of the COVID-19 pandemic on the socioemotional development of infants and toddlers.
Eosinophils and mast cells as therapeutic targets in pediatric functional dyspepsia. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Effects of hydration and dehydration on blood rheology in sickle cell trait carriers during exercise. J Pain Manag. 2019;12(2):141-146. doi:10.4292/wjgpt.v4.i4.86
For patients who are elderly, orthostasis is an unreliable clinical finding and may be present in the absence of dehydration. 36-37 There is little evidence regarding oral rehydration in adults with gastroenteritis, though it seems reasonable that adults with mild dehydration could be safely hydrated orally. Modified from: Pringle, K.,
It is also worth noting that these aggressive hematologic cancers occur more commonly in children and thus the risk of TLS can be higher in the pediatric population6. mg/dl (pediatrics) calcium < 7 mg/dl Clinical Tumor Lysis Syndrome (2) - laboratory TLS + one of the following: cardiac arrhythmia seizure sudden death creatinine > 1.5x
Inadequate fluid consumption, combined with factors like hot weather or strenuous physical activity, can lead to gradual dehydration with cumulative effects. Differential Diagnosis of Acute Issues Dehydration Every child will have a minimum daily fluid intake goal to achieve. Pediatric nephrology , 22 (9), pp.1243-1250.
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