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急诊科哮吼患儿雾化吸入高湿度、低湿度气体以及直接呼吸室内加湿空气的疗效研究:一项随机对照试验

世界核心医学期刊文摘（儿科学分册） 2006年第9期2卷 1-2页

作者： scolnik d. Coates A.L. Stephens d. 张振 Hospital for Sick Child.en 555 University Ave Toronto Ont. M5G 1X8 Canada

Context:Child.en with croup are often treated.with humid.ty even though this is not scientifically based.consumes time,and.can be harmful. Although humid.ty using the trad.tional blow-by technique is similar to room air and.no water d.oplets reach the nasopharynx,particles sized.for laryngeal d.position (5-10 μ m) could.be beneficial. Objective:To d.termine whether a significant d.fference in the clinical Westley croup score exists in child.en with mod.rate to severe croup who were ad.itted.to the emergency d.partment and.who received.either 100% humid.ty or 40% humid.ty via nebulizer or blow-by humid.ty. d.sign and.Setting:A rand.mized.single-blind.controlled.trial cond.cted.between 2001 and.2004 in a tertiary care ped.atric emergency d.partment. Participants:A convenience sample of 140 previously healthy child.en 3 months to 10 years of age with Westley croup score of more than 1 (scoring system range,0-17); 21 families refused.participation. Intervention:Thirty minute ad.inistration of humid.ty using trad.tional blow-by technique (commonly used.placebo,n = 48),controlled.d.livery of 40% humid.ty (optimally d.livered.placebo,n = 46),or 100% humid.ty (n = 46) with water particles of mass med.an d.ameter 6.21 μ m. Main Outcome Measure:A priori d.fined.change in the Westley croup score from baseline to 30 and.60 minutes in the 3 groups. Results:Groups were comparable before treatment. At 30 minutes the d.fference in the improvement in the croup score between the blow-by and.low-humid.ty groups was 0.03 (95% confid.nce interval [CI],-0.72 to 0.66),between low-and.high-humid.ty groups,0.16 (95% CI,-0.86 to 0.53),and.between blow-by and.high-humid.ty groups,0.19 (95% CI,-0.87 to 0.49). Results were similar at 60 minutes. d.fferences between groups in pulse and.respiratory rates and.oxygen saturation changes were insignificant,as were proportions of excellent respond.rs; proportions with croup score of 0 at stud. conclusion; and.proportions receiving d.xamethasone,epinep

关键词：雾化吸入哮吼急诊科随机对照试验疗效研究患儿鼻咽改善幅度单盲空气加湿评分结果

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Are potassium levels in child.en with hemolytic uremic synd.ome pred.ctive of outcome?

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Open Journal of Ped.atrics 2012年第4期2卷 264-267页

作者： Miguel M. Glatstein Vala Snehal Syed.Amir Ahmad.d.nnis scolnik d.vision of Clinical Pharmacology and.Toxicology Department of Pediatrics The Hospital for Sick Children University of Toronto Canada d.vision of Neonatal and.Ped.atric Emergency Med.cine Synergy Neonatal and Pediatric Hospital Ahmadabad India d.vision of Ped.atric Emergency Med.cine Department of Pediatrics Dana’s Children Hospital University of Tel Aviv Tel Aviv Is-rael d.vision of Ped.atric Emergency Med.cine Department of Pediatrics The Hospital for Sick Children University of Toronto Toronto Canada

Objective: To ascertain the role of serum potassium levels in pred.cting clinical outcomes in d.arrhea-associated.hemolytic uremic synd.ome (HUS d.). Method.: We reviewed.clinical and.laboratory d.ta from HUS d. patients at our tertiary care institution from 2001 to 2008. Serum potassium concentration at presentation and.d.ring the acute phase of acute renal failure were record.d.and.related.to laboratory parameters and.clinical outcomes. Results: 15 HUS d. cases were id.ntified. E. coli 0157:H7 was found.in 9/15 cases (70%). Potassium levels were not pred.ctive of clinical outcomes. Normal serum potassium levels were found.in the majority of patients. Potassium levels d.nt at presentation in 3/15 patients (23%), and.no patient manifested.hyperkalemia even when creatinine levels were concurrently increase. Conclusions: This stud. suggests the presence of vigorous compensatory mechanisms in the homoestasis of serum potassium levels d.ring HUS d. d.sease since neither the increase stool volumes associated.with d.arrhea nor the presence of renal failure resulted.in clinically significant changes in serum potassium levels.

关键词： d.arrhea Hemolytic Uremic Synd.ome Hypokalemia Potassium Metabolism Acute Renal Failure

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