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Mihai Craiu

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Treatment of acute dehydration in children with gastroenteritis

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Treatment of acute dehydration in children with gastroenteritis

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ABSTRACT

Acute gastroenteritis is frequent in children worldwide. Mortality induced by acute dehydration in children with gastroenteritis is the third cause of death after peri-natal death and respiratory diseases induced death. Main pathogenetic mechanism of severe outcome is dehydration. Our paper presents diagnostic features and treatment approaches in children with acute dehydration induced by enteritis. Objective tools generated by experts [PALS and ERC] are presented and practical case-scenarios are provided.

Key words: children, enterocolitis, dehydration, rehydration salts, crystalloid solutions, fluid bolus, intraosseous approach

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TRATAMENTUL DESHIDRATARII ACUTE LA COPILUL CU GASTROENTERITA

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 1, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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TRATAMENTUL DESHIDRATARII ACUTE LA COPILUL CU GASTROENTERITA

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REZUMAT

Boala diareică acută (BDA) reprezintă o cauză frecventă de morbiditate la toate grupele de vârstă şi a treia cauză de mortalitate, la copilul sub 5 ani, după decesele perinatale şi afecţiunile respiratorii. Copiii, în special cei cu vârstă mică, sunt deseori afectaţi de forme severe de BDA, principalul mecanism generator de complicaţii cu risc letal fiind deshidratarea acută. Articolul de faţă doreşte a fi o punere la punct a celor mai noi recomandări de evaluare şi de tratament în deshidratările acute la copil. Este subliniat rolul evaluării semnelor precoce de şoc, precum şi al semnelor de mare gravitate, folosind algoritmii European Resuscitation Council şi criteriile Pediatric Advanced Life Support. Sunt date exemple practice de evaluare şi de tratament, fiind detaliate opţiunile de rehidratare în funcţie de severitate şi comorbidităţi.

Cuvinte cheie: copil, enterocolită, deshidratare, săruri de rehidratare, soluţii de cristaloizi, bolus de fluide, abord intraosos

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UTILITATEA MASURARII FENO IN MONITORIZAREA COPIILOR CU ASTM BRONSIC

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 2, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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UTILITATEA MASURARII FENO IN MONITORIZAREA COPIILOR CU ASTM BRONSIC

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REZUMAT

Scopuri şi obiective. Astmul bronşic este cea mai frecventă boală cronică la copii. În peste 50% din cazurile pediatrice, inflamaţia căilor aeriene este eozinofilică. În monitorizarea astmului, cel mai important aspect este prevenirea exacerbărilor printr-o bună comunicare medic-pacient-familie şi o complianţă ridicată a acestora din urmă la tratament. Foarte importantă este şi evaluarea corectă a calităţii vieţii copilului cu astm. Studiul de faţă şi-a propus verificarea corelaţiei între nivelul de control al astmului şi nivelul de inflamaţie eozinofilică de la nivelul căilor aeriene la copiii aflaţi în tratament cu corticosteroizi inhalatorii (CSI).

Material şi metodă. Am evaluat un număr de 24 pacienţi care s-au prezentat la compartimentul de primiri urgenţe al spitalului IOMC „Alfred Rusescu“ Bucureşti în cursul a zece săptămâni din anotimpul rece. Evaluarea a constat în efectuarea scorului Asthma Control Test (ACT), măsurarea fracţiei de Oxid Nitric din aerul expirat (FeNO) şi probe funcţionale respiratorii.

Rezultate şi discuţii. Valoarea scorului ACT în funcţie de măsurarea FENO arată o corelaţie liniară şi negativă cu r = -0.6286 (p < 0,01). Concluzii. Măsurarea FeNO este o metodă simplă, rapidă şi neinvazivă. Valoarea FeNO este corelată cu scorul ACT, în mod liniar şi negativ. Crearea unor algoritmi simpli ar putea îmbunătăţi controlul şi monitorizarea evoluţiei şi ar permite personalizarea terapiei la copilul cu astm.

Cuvinte cheie: scor ACT, FeNO, monitorizare, copil

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THE UTILITY OF MEASURING FENO IN MONITORING ASTHMATIC CHILDREN

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 2, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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THE UTILITY OF MEASURING FENO IN MONITORING ASTHMATIC CHILDREN

and

ABSTRACT

Purposes and objectives. Bronchial asthma is the most frequent chronic disease in children and in almost 50% of these cases, it occurs eosinophilic airway infl ammation. The most important objective in monitoring asthma is preventing exacerbations by means of good communication between phisician, patient and family, a good compliance of the latter and an accurate assesment of the asthmatic patient’s quality of life. Present study is examining correlation between asthma control and airways eosinophilic infl ammation level in asthmatic children treated with ICS.

Method and material. We evaluated 24 patients presented in emergengy department of our hospital, during ten weeks in cold season. The assesment consisted in performing Asthma Control Test (ACT), measuring fraction of the exhaled nitric oxide (FeNO) and pulmonary function testing. Results and discussions. We documented a negative linear correlation of ACT score with FeNO (r = -0. 6286 (p < 0.01)).

Conclusions. Measuring FeNO is a simple to perform, fast and noninvasive method. FeNO value is related to ACT score, between them being a negative linear correlation. Generating simple algorithms may improve control of disease and tailoring therapy asthmatic children.

Keywords: ACT score, FeNO, monitoring, child

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ABORDUL INTRAOSOS, METODA CLASICA DE ACCES VASCULAR REVENITA IN ACTUALITATE

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ABORDUL INTRAOSOS, METODA CLASICA DE ACCES VASCULAR REVENITA IN ACTUALITATE

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REZUMAT

75-80% dintre situaţiile ameninţătoare de viaţă, cu stop cardio-respirator neaşteptat, se petrec în afara spitalului (1). De aceea este întâlnită frecvent situaţia unei resuscitări dificile. Principala cauză de eşec este obţinerea tardivă a unei căi de acces vascular pentru administrarea fluidelor şi medicaţiei necesare în aceste situaţii (2). Abordul intraosos este folosit în tratamentul pacienţilor aflaţi în situaţii ameninţătoare de viaţă şi care nu au alt acces vascular instalat anterior (3). Lucrarea de faţă trece în revistă aspecte ale dezvoltării acestei tehnici de acces vascular rapid şi aplicaţiile ei actuale în medicina de urgenţă, prin prisma noilor ghiduri de resuscitare la copil, apărute sub egida European Resuscitation Council (4).

Cuvinte cheie: acces intraosos, resuscitare

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INTRAOSSEOUS ACCESS – A CLASSICAL METHOD FOR VASCULAR ACCESS THAT REGAINS AN IMPORTANT ROLE AS RESUSCITATION TOOL

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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INTRAOSSEOUS ACCESS – A CLASSICAL METHOD FOR VASCULAR ACCESS THAT REGAINS AN IMPORTANT ROLE AS RESUSCITATION TOOL

, and

ABSTRACT

75-80% of life threatening situations, with unexpected arrest, are documented out of hospital (1). This situation generates frequently a difficult resuscitation. Main cause for failure is delay in gaining vascular access for fluid and drug delivery (2). Intraosseous access (IO) is used for treatment in patients without a previously placed intravenous line that experience abrupt-onset life threatening situations (3). Authors revisit data from initial development of this method and document the role of IO access as a valuable tool during resuscitation according to European Resuscitation Council Guidelines 2010 (4). Particular aspects of technique, improvisations and real life trouble shooting issues are presented from a single pediatric Emergency Department experience.

Keywords: intraosseous access, resuscitation

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