Toxic shock syndrome in a scald burn child treated with an occlusive wound dressing.
Explore the source record for details and available documents.
Biocompatible Materials↗
Biomedical subjects
M Trop
Publications and source records attributed to M Trop.
[Congenital malaria due to Plasmodium falciparum and Plasmodium malariae].
Increasing tourism and growing numbers of immigrants from malaria-endemic countries are leading to a higher importation rate of rare tropical disorders in European countries. We describe, to the best of our knowledge, the first case of connatal malaria in Austria. The patient is the first child of a 24 year old mother who was born in Ghana and immigrated to Austria one and a half years before delivery. She did not stay in an endemic region during this period and did not show fever or any other signs of malaria. The boy was healthy for the first six weeks of his life. In the 8th week of life he was admitted to our hospital due to persistent fever of unknown origin. On physical examination he showed only mild splenomegaly. Routine laboratory testing revealed mild hemolytic anemia with a hemoglobin value of 8.3 g/l. In the blood smear Plasmodium falciparum and Plasmodium malariae were detected. Oral therapy with quinine hydrochloride was successful and blood smears became negative for Plasmodia within 6 days. This case shows that congenital malaria can occur in children of clinically healthy women who were born in malaria-endemic areas even one and a half year after they have immigrated to non-endemic regions.
Adult↗
Controlled mechanical hypoventilation in a paediatric burn patient as treatment of acute respiratory distress syndrome.
The paediatric patient we are describing suffered a scald injury covering 83 per cent of the total body surface area (TBSA). This injury was complicated by Klebsiella pneumoniae septicaemia resulting in multiorgan failure (MOF). Acute respiratory distress syndrome (ARDS), gastrointestinal insufficiency, hepathopathy and wound conversion to full thickness posed the main problems. The boy was ventilated with pressure-controlled mechanical ventilation. The concept of permissive hypercapnia (PHC) resulted in a complete resolution of ARDS within 4 weeks. From our experience, further lung injury among infants and children suffering from severe ARDS can be avoided by using controlled mechanical hypoventilation. It is a simple and safe technique that allows adequate oxygenation.
Accidents, Home↗
Congenital central hypoventilation syndrome (Ondine's curse syndrome) in two siblings: delayed diagnosis and successful noninvasive treatment.
UNLABELLED: Congenital central hypoventilation syndrome (CCHS, Ondine's curse syndrome) is a rare respiratory disorder; less than 100 cases have been reported. Familiality of the disease has been discussed, but only few familial cases have been reported so far. In this report we describe the occurrence of CCHS in two male siblings. Diagnosis was established only at the age of 4 years in the first case, although the patient had disease related symptoms since early infancy. The second patient was one of dizygotic twins, he was diagnosed with CCHS at the age of 8 months. Up to that age only moderate desaturations had been observed. The other twin was unaffected by the disease. Both patients were successfully treated by nocturnal positive-pressure ventilation via a specially adapted face mask. They show satisfactory physical and neurologic development. CONCLUSION: Our cases support the assumption of familiality in CCHS although the mode of inheritance remains to be clarified. Polygraphic recordings including capnography should be performed in siblings of CCHS patients early in life in order to avoid secondary complications. Noninvasive treatment by ventilation via special face masks is feasible.
Child↗
Inhaled nitric oxide in pediatric intensive care.
Explore the source record for details and available documents.
Administration, Inhalation↗
Procel burn cover used as a total body dressing in burns.
A 26-month-old boy sustained a scald injury covering 83 per cent of his total body surface area (TBSA). He also developed sepsis and multiorgan failure (MOF). Locally he was treated with Procel burn cover and silver sulphadiazine cream (SSD) for 23 days. By using Procel, the dressing-change time was shortened significantly. Procel burn cover controlled core and skin temperature more effectively compared to conventional dressing, and the staff acceptance increased because of its easy and fast use. Based on our observation, this material can be used successfully as a total body dressing with children with extensive partial thickness burns or temporarily in full thickness burns until wound excision can be performed.
Bandages↗
[Extracorporeal membrane oxygenation in newborn infants and children].
The purpose of this report is to describe our experience with veno-arterial (VA) and veno-venous extracorporeal membrane oxygenation (VV-ECMO) for neonates and children with severe acute respiratory or cardiocirculatory failure. From 1990 to 1994 20 neonates and 12 children were treated at the ECMO center in Graz. Indications for ECMO were acute respiratory failure in 27 patients and cardiocirculatory failure in 5 patients. Mean duration of ECMO was 228 +/- 30 hours. Fifteen neonates were weaned from ECMO and were subsequently extubated. Of the 12 children 7 had severe acute respiratory failure and underwent VV-ECMO. Five of these 7 children were weaned from ECMO and subsequently extubated. Only two of 5 patients with cardiac ECMO support could be weaned from bypass; one patient subsequently died, but the other patient is a long-term survivor. All patients with cardiac ECMO support after open heart surgery had severe mediastinal bleeding. The survival rate in neonates and pediatric patients with respiratory failure treated by ECMO was 75% and 71%, respectively, whereas it was only 20% in children with cardiocirculatory failure. Major complications on ECMO were local and intracerebral bleeding. ECMO is an effective therapy for neonates and children with acute respiratory failure. It is less effective for cardiac support in children after open heart surgery, but the use of heparin-layered ECMO systems might increase the safety of the procedure.
Carbon Dioxide↗
Tick-borne encephalitis in a 3-month-old child.
Tick-borne encephalitis has not been reported in infants younger than 12 months of age. We report a 3.5-month-old child with a serologically proven tick-borne encephalitis. The infant had a history of a tick bite 3.5 weeks before the first symptoms of encephalitis appeared. The family lives in an endemic area of the disease. There were no prodromal signs and the course of the disease was monophasic. In an endemic area, prophylactic treatment with hyperimmunoglobulin after a tick bite should be considered even in very young infants, but in most children active immunization is probably not necessary because of infrequent exposure. Active immunization is still recommended after the 1st year of life.
Age Factors↗
Effect of acute and chronic lipopolysaccharide (LPS) administration on reticuloendothelial system (RES) phagocytic activity in vivo.
The effect of injection or chronic infusion of lipopolysaccharide (LPS) into unanaesthetized rats on the distribution of [99Tcm-]SC has been determined. At a dose of 2.5 mg/kg, LPS injection caused a marked alteration in the distribution of the radiolabelled material, with more uptake being achieved in the lung while less was taken up by the spleen. Kidney and liver uptake were also changed. Chronic infusion of LPS at a similar dose (3 mg/kg in 24 h) caused a marked increase in the uptake of the radioactive material by the lung only. These data are consistent with a working hypothesis that the alterations in RES phagocytic activity of the lung observed in rats subjected to burn trauma could be related in part to LPS, either coming as a bolus, or being continuously presented.
Animals↗
Effect of chronic interleukin-2 treatment on RES phagocytic activity in the rat.
The effect of chronic interleukin-2 (IL-2) injection upon reticuloendothelial system (RES) function in the rat has been determined. Seven-day treatments with two doses of human recombinant IL-2 resulted in a dramatic reduction in the phagocytic uptake of the liver and spleen, while increasing the weight of both organs. There were dramatic histological changes in the intestine, liver and spleen as well. These results suggest that the chronic use of IL-2 can result in hepatic dysfunction, which is associated with altered RES phagocytic function.
Animals↗
Effect of heta-starch colloidal solutions on reticuloendothelial phagocytic system (RES) function in burned and infected rats.
The biodistribution of the plasma expander colloidal solution, heta-starch (HES), has been examined in rats, subjected to thermal injury or sepsis. The ability of these solutions to alter RES phagocytic function of [99mTc]-sulphur colloid ([99mTc]SC) uptake in vivo has been examined. The biodistribution of radiolabelled HES has been determined in normal rats. The HES colloidal solution has no deleterious effect upon RES function in vivo in the thermally injured animals or the septic animals as compared to sham controls. In addition, the HES colloidal solution seemed to be distributed primarily within the liver, spleen and kidney, with a small amount residing in the lung. Thermal injury did not increase the uptake of this material by the lung. These results suggest that the use of HES in thermally injured and septic individuals has no deleterious effects on RES function, nor does it accumulate in the lungs, and hence, should be advocated for use in these situations.
Animals↗
Haemophilus influenzae epiglottitis occurring simultaneously in two siblings.
Intrafamilial spread of Haemophilus influenzae type B disease has often been described for meningitis, but rarely for epiglottitis. Here we report for the first time epiglottitis occurring simultaneously in two siblings and comment on the value of chemoprophylaxis and vaccination to prevent secondary and primary disease.
Bacterial Capsules↗
Platelet-activating factor induces intestinal necrosis, but not septic shock, in germ-free and specific-pathogen-free rodents.
Platelet-activating factor (PAF) was injected into conventional mice, endotoxin-resistant mice (C3H/HEJ), conventional rats, germ-free rats and specific-pathogen-free (SPF) mice. The PAF resulted in significant necrosis and damage to the small intestines of all the animals tested. In general, the frequency and severity of the lesions were similar in all groups. All the conventional rats and mice, as well as the endotoxin-resistant HEJ mice, were dead 18 h after the injection of the PAF, while all the germ-free rats and the SPF mice survived. These data demonstrate that development of massive intestinal lesions, in the absence of aerobic bacteria, is not sufficient to cause the death of the host from septic shock and endotoxaemia.
Animals↗
Effect of haemolysis on reticuloendothelial system (RES) phagocytic activity in rats.
The role of haemolysis of blood in the alterations in the uptake of [99mTc]SC ([99mTc]-sulphur colloid) in vivo in the rat has been examined. When the haemolysed blood (produced by first freezing the blood in liquid nitrogen) was infused into synergenic Lewis rats via the tail vein, there was a significant reduction in the uptake of the [99mTc]SC by the spleen, but lung, liver and kidney uptake remained constant. These results suggest that haemolysis of the blood may play a role in the alterations in RES phagocytic activity observed in the spleen following thermal injury.
Animals↗
Effect of platelet activating factor on reticuloendothelial system function.
The effect of platelet activating factor (PAF) injections on the uptake of 99mTc-SC (99mTc-SC (99mTc-sulphur colloid) was determined in vivo. PAF (2 micrograms) injected intravenously into unanaesthetized, unrestrained rats was associated with the development of lesions in the small intestine and alteration of 99mTc-SC uptake in vivo. 99mTc-SC uptake into the lung was increased while spleen uptake was decreased. Pretreatment of the animals with a PAF antagonist, SRI-64-441, prevented the intestinal lesions and alterations of 99mTc-SC uptake. Macrophages, isolated from lung lavage of the PAF-treated rats, demonstrated a decreased generation of hydrogen peroxide in vitro. The present results suggest that, in addition to its other effects on the immune system, PAF can also alter the in vivo phagocytic activity of the reticuloendothelial system in the rat.
Animals↗
Parenteral nutrition during continuous arteriovenous hemofiltration in critically ill anuric children.
Explore the source record for details and available documents.
Acute Kidney Injury↗
[A clinical score system for children with ARDS].
In a retrospective study we developed a simple acute respiratory distress syndrome (ARDS) scoring system in order to analyze the severity of ARDS as precisely as possible. From March 1983 to May 1990, 17 children with ARDS were admitted and treated at the pediatric intensive care unit of the University Hospital of Graz. The ARDS score was evaluated as a predictor of outcome. The score is based on four variables: mean airway pressure, oxygenation index, additional number of organ system failure and a radiological score, each of which was assigned a score between 0 and 3 (Table 3). The score was recorded on admission or immediately after respiratory failure and after 24, 48 and 72 h. The patients were divided into survivors and non-survivors. After 24 h of mechanical ventilation the ARDS score was 7.16 +/- 0.79 in survivors and 10.4 +/- 0.4 points in non-survivors (P less than 0.0006). Similar differences were found after 48 and 72 h of therapy. In addition, the predictive power of the ARDS score after 24 h was tested at a level of 8 points. The sensitivity and the positive predictive value were 90%, while specificity and negative predictive value were 85.7%. The correct prediction was 88.2%. We conclude that this simple ARDS score can be an useful prognostic factor in patients with ARDS.
Carbon Dioxide↗
Role of neutrophils in the intestinal alterations associated with thermal injury.
We have examined the role of neutrophils in the alterations observed in the intestines of rats subjected to 40 per cent surface area scald injury. Histologically, there was no evidence of neutrophilia in the intestinal tissue, and myeloperoxidase activity in mucosal scrapings was not elevated. The distribution of labelled human neutrophils injected into the burned rats showed no enhancement of uptake in the intestines, although there was increased uptake by the lung. The present data suggest that neutrophil migration may not play a role in the alterations in small intestinal function and morphology seen in burn trauma in the rat, but may be a factor in lung damage associated with thermal injury.
Acute Disease↗