Eukocyte thrombus METHODS. After IRB approval of medical records of all patients admitted to our ICU with a diagnosis of whooping cough 1997-2007 Danusertib PHA-739358 were evaluated. Patients with severe pertussis requiring intubation and mechanical ventilation, and examined with an echocardiographic diagnosis of pulmonary hypertension. RESULTS. Six patients were identified that met the above criteria. We previously described four of these patients, the ECMO support for severe whooping cough, and requiring that all died of severe pulmonary hypertension refractory (Pediatrics, 2003, 112:1274 78th Since 2003 we have 2 F Ll subsequently identified The heavy infantile pertussis with good results. Both patients were treated leukapheresis to achieve leukoreduction.
The first patient had significant respiratory and kardiovaskul instability re t and was originally placed on ECMO Triciribine for stabilization and then underwent leukapheresis. We reported this case in detail (PCCM 2006, 7:580 582nd A second younger patients is not reported is now described in more detail. The patient was a 5-week-old S ugling, who was m male pattern admitted to the ICU on his h Pital of the fifth day. two days sp ter he was intubated and under mechanical ventilation for respiratory failure and a presumptive diagnosis (pertussis subsequently end best CONFIRMS was. In After two days he had evidence of PHT ECHO and his WBC increased hte to 90.8K. He underwent autograft . his WBC 28.4K and monitoring has been reduced ECHO was no evidence of PHT. He survived the start and was discharged.
CONCLUSION. on our current experiences, and other cases F already VER were published, we propose an algorithm for the recognition of critically ill S uglinge with severe pertussis. pertussis lung injury induced by mechanical ventilation and evidence of pulmonary hypertension. Or WBC [100K YES, if the heart and respiratory condition stable than leukapheresis or double volume exchange transfusion (DVET. If unstable place of ECMO (if available at the bridge or leukapheresis DVET. If no evidence of PHT and WBC continue to support 100K files and monitoring the trend of PHT and WBC. PHT by a pressure equal to or greater he defined as a systemic RV 1/2. milrinone in 0555 PEDIATRICS septic shock Mendes1 C., B. Robalo1, J. Fermeiro1, F. Abecasis1, Mr. Vieira1, J. Pereira1, R. Anjos2, Mr.
Correia1, G. Rodrigues1 1Paediatric ICU, H Pital Santa Maria, 2Paediatric Cardiology, H Pital Santa are Cruz, Lisbon, Portugal INTRODUCTION. heavy p pediatric septic shock is h frequently by depressed myocardial function with high systemic vascular resistant assigned. Under these circumstances ends milrinone may be a valuable tool for cardiovascular support in children with septic his shock, because of its inotropic effect (low myocardial oxygen consumption and found expanding properties. METHODS. We admitted reviewed the clinical data of patients with septic shock, our PICU from January 2005 to M March 2008, which were treated with milrinone. Demographics, clinical and laboratory data were analyzed. RESULTS.
Zw lf patients were again u milrinone may need during the study period, but one patient was excluded because of the therapeutic dose of milrinone below. The median age of patients was 11 3 contain years and 3 months (3 months to 7 years. All patient volume for CVP were [10 cmH2O. Dopamine is the first inotropic agent in all patients used. milrinone was revived using the second agent in 4 patients. The mean interval between admission and administration of milrinone was 15 hours. Only one patient re u is an initial dose of milrinone (50mcg/Kg. first infusion dose ranges from 0.25 0.75 mcg / kg / min, maximum rate of infusion was 0.82mcg/kg/min. The median duration of infusion of milrinone concerning gt 72 hours of nine patients required three or more inotropes (re 7 noradrenaline u Cardiac function was assessed by echocardiography in 8 patients before and after the judges milrinone was launched.
. 5 improvement, two had no Ver change what a deteriorated Herzkontraktilit t blood lactate obtained ht and reduced in 2 patients in 7 patients (mean of 20.1 mg / dl after the start of milrinone With regard to the adverse effects of milrinone:.. the mean arterial pressure in 4 patients ( an average decrease of 10 mmHg, 5 decreased patient ben had ht saturated norepinephrine or Dosiserh increase began after milrinone infusion, the heart rate by 7 erh developed ben no disrythmia, 2 patients had secondary re thrombocytopenia. Seven patients saturated mechanical respiration, 4 required renal replacement therapy techniques, none had had ARDS and one patient severe isch chemical sequelae, which was amputation of the lower limbs. The median PRISM-scale 23 The mortality tsrate was 18% (2/11. CONCLUSION. milrinone has shown promising results with minimal side effects. In our patients, despite lack of h hemodynamic monitoring were the results in terms of cardiac function and peripheral circulation f rdern. A controlled study The randomized milrinone