RESUMO
To evaluate the pulsed Doppler cardiac output method as a noninvasive means for determining cardiac output in critically ill children, we performed paired pulsed Doppler and thermodilution cardiac output determinations in 17 critically ill children. Commercially available equipment, specifically designed for this purpose, was employed. Forty paired thermodilution and pulsed Doppler determinations were made. There was a significant correlation between the two measurements (pulsed Doppler = 0.84 thermodilution + 0.39; r = 0.79, p less than 0.01). The ranges of thermodilution measurements (1.02 to 6.26 L/min; median 2.77 L/min) and pulsed Doppler measurements (1.13 to 6.35 L/min; median 2.57 L/min) were not different (p = 0.25). However, differences between individual paired thermodilution and pulsed Doppler measurements were large (-3.13 to 2.03 L/min; median 0.12 L/min), and the percentage difference between individual paired thermodilution and pulsed Doppler measurements ranged from 0.41% to 102.5% (median 12.7%). A discrepancy of 15% or more between thermodilution and pulsed Doppler was encountered in 18 (45%) of 40 of paired measurements (95% confidence interval: 29% to 61%), and one fourth of the paired measurements differed by more than 25%. We conclude that, as employed in this study, pulsed Doppler cardiac output determination is not sufficiently representative of the thermodilution output to be employed for hemodynamic monitoring in critically ill children.
Assuntos
Débito Cardíaco , Ecocardiografia Doppler , Termodiluição , Adolescente , Cateterismo Cardíaco , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Artéria PulmonarRESUMO
Exponemos nuestra experiencia en cincuenta y cinco casos de sindrome de Schoenlein-Henoch con afeccion renal. Desde el punto de vista clinico se clasificaron en cinco grupos: 1) Hematuria y proteinuria, 2) Hematuria y sindrome nefrotico, 3) Hematuria 4) Hematuria, sindrome nefrotico e insuficiencia renal y 5) proteinuria. Desde el punto de vista anatomico se clasificaron en seis tipos segun los criterios del ISKDC. Se halla correlacion en cuanto a peor pronostico en la forma clinica de inicio con sidrome nefrotico e insuficiencia renal y en la lesion anatomica con semilunas en porcentaje superior al 75% de los glomerulos
Assuntos
Pré-Escolar , Criança , Adolescente , Humanos , Masculino , Feminino , Nefropatias , Vasculite por IgARESUMO
In our experience, hypervitaminosis D, which at present should only be a historic remembrance in pediatrics, is still a frequent cause of hipercalcemia in childhood. It is easy understand that its appearance should turn out to be a complication in the treatment of hypoparathyroidisms or in vitamin D resistant rickets, but its persistance as a purely iatrogenic diseases is at present inexplicable. The frequency with which we have seen it has led us to review 15 cases where erroneous administration of high doses of vitamin D has resulted in serious clinical, biological and anatomical problems.