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

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.

Objective To observe the change of gastric mucosal-arterial partial pressure of carbon dioxide gap [p(g-a)(CO2)] in septic shock rabbit.Methods Sixteen anesthetized and mechanically ventilated rabbit were randomly assigned to 2 groups:shock group(n=8) and control group(n=8).The rabbit in shock group were challenged with intravenous injection of 2 mg/kg Lipopolysaccharides from Escherichia coli.The rabbit in control group were intravenous injection of normal saline solution.Mean arterial pressure(MAP) and heart rate were continuously recorded by multichannel physiologic recorder.Cardiac index(CI) and superior mesenteric blood flow index(SMBFI) were continuously monitored by doppler flowmeter.Gastric mucosal partial pressure of carbon dioxide [pg(CO2)] was evaluated by gas tonometry every 10 min.Arterial and venous blood gas analysis,hemoglobin,and lactate levels were measured every 1 hour.Results The parameters remained stable in control group,but the parameters changed significantly in shock group.Compared with baseline levels,2 hours after Lipopolysaccharides infusion in shock group,MAP decreased from(78?5) mmHg to(50?2) mmHg(1 mmHg=0.133 kPa)(F=145.3 P