Current Pediatric Reviews - Volume 2, Issue 3, 2006

Adequate functional residual capacity (FRC) is difficult to create with manual ventilation in very preterm infants and carries a high risk for creating lung damage. International guidelines for neonatal resuscitation do not provide ventilation guidelines for very preterm infants despite evidence that a different approach may be warranted. Peak inspiratory pressures (PIPs) generated with bag and mask ventilation are usually insufficie Read More

The carotid bodies are the main peripheral oxygen sensors involved in cardio-respiratory control under normoxic and hypoxic conditions. The present review briefly describes carotid body function during "normal" development and then presents recent results showing how environmental factors affect the trajectory of these developmental processes. This review then focuses on data obtained from our laboratories, which Read More

Blood pressure is the direct product of cardiac output and total peripheral resistance. Cardiac output is regulated by preload, myocardium contractility and heart rate, while total peripheral resistance depends on afterload and vessel elasticity. The maintenance of blood pressure within normal limits is influenced by neural, humoral and local control mechanisms, which have extensive and complex interactions, making dif Read More

Assessment of renal function is important. The gold-standard marker is glomerular filtration rate (GFR) measured by inulin clearance normalized to a standard body surface area of 1.73 m2. Inulin, no longer available in North America, has been replaced by nuclear medicine tests such as 51Cr EDTA, 99mTc DTPA and iothalamate clearances. The use of serum creatinine as a surrogate endogenous marker is hampered by height, Read More

Malnutrition is highly prevalent in critically ill children. Several studies have recently reinforced the relationship between poor nutritional status and higher incidences of complications, mortality, length of hospital stay and costs. A variety of methods used for assessment of different components of energy expenditure has been validated and used in critically ill children. Although reference values derived from representative group Read More

Pain arising from the chest area creates anxiety in children and their parents, often leading to unnecessary activity restriction, school absences, and medical utilization. A thorough but pragmatic evaluation requires a grasp of the pathophysiology of several organ systems and an understanding of epidemiologic and behavioral patterns specific to children. Few symptoms in pediatrics test a clinician's skill more than Read More

The incidence of complicated parapneumonic effusions in children has been increasing over the past decade despite the increasing use of protein-conjugate vaccines against Streptococcus pneumoniae, the most common cause of complicated pneumonia in children in the developed world. Despite the fact that this condition is increasingly common in hospitalized children, the management of this condition remains controver Read More

The purpose of this systematic review is to investigate back pain as a clinical presentation in childhood and adolescence providing the clinician with a comprehensive approach, which will enable for an early recognition of those spinal disorders in need of more aggressive medical intervention. The current literature suggests that young people have a fairly high incidence of non-specific back pain, which seems to be much more Read More