Analgesia ; methods ; Analgesics ; therapeutic use ; Child ; Conscious Sedation ; methods ; Critical Illness ; therapy ; Electroencephalography ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Intensive Care Units, Pediatric ; Pain Measurement ; methods ; Severity of Illness Index

Adrenal Cortex Diseases ; etiology ; Child ; Humans ; Sepsis ; complications ; physiopathology ; Shock, Septic ; complications ; physiopathology

Enteral Nutrition ; methods ; Enterocolitis, Necrotizing ; mortality ; prevention & control ; Gastrointestinal Tract ; microbiology ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; mortality ; prevention & control ; Pharmaceutical Preparations ; Probiotics ; administration & dosage ; therapeutic use ; Sepsis ; mortality ; prevention & control

Child ; Community-Acquired Infections ; microbiology ; Humans ; Pneumonia, Bacterial ; microbiology

Objective To explore the effect of endotracheal intubation therapy on acute laryngotracheobronchitis and acute laryngitis in children.Methods Twelve of 45 children with acute laryngotracheobronchitis or acute laryngitis were intubated and mechanically ventilated in pediatric intensive care unit (PICU) during Oct. 2000 to Oct. 2006.Ten cases were laryngotracheobronchitis and 2 were acute laryngitis.The endotracheal tube chosen was at least 0.5 to 1.0 size smaller than normally recommended for age.The need of intubation was assessed based on severity of signs of airway obstruction Ⅲ without improvement by the conventional treatment with humidified and combined with oral or intravenous interventions,respiratory failure,or airway obstruction Ⅳ.Results Eleven of 12 children were intubated successfully,except 1 case after resuscitation.All the patients were ventilated after intubation.The mean duration of intubation was 3.4 days (24 hours -9 days).Ten cases were successfully extubated and 2 cases failed of extubation,of which 1 case got tracheostomy.All children were routinely supported by nasal continuous positive airway pressure(NCPAP) after extubation with a mean of 1.5 days (2 hours-4 days).The mean days of hospitalization were 11.2 days (4-22 days).Conclusion Intubation is an alternative for the management of severe acute laryngotracheobronchitis and acute laryngitis in children.In most cases,tracheotomy can be substituted by intubation.