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111.
目的:探讨儿科重症监护室(PICU)脓毒血症血培养病原菌的分布特点及其耐药情况,为临床诊疗提供参考。方法:对苏州大学附属儿童医院2008年6月至2011年6月PICU送检的脓毒血症血液标本所分离病原菌的分布及药敏结果进行回顾性分析。结果:共检出45株病原菌,其中革兰阳性(G+)菌29株(64.4%)、革兰阴性菌(G-)15株(33.3%)、真菌1株(2.2%)。前3位的病原菌依次为表皮葡萄球菌(22.2%)、肺炎链球菌(17.8%)、铜绿假单胞菌(17.8%)。G+球菌对儿科常用的β-内酰胺类药物多数耐药,而对万古霉素、复方磺胺甲唑敏感性较高;G-杆菌对第三代头孢菌素高度耐药,而对亚胺培南、环丙沙星、左氧氟沙星敏感性较高。结论:表皮葡萄球菌、肺炎链球菌、铜绿假单胞菌等条件致病菌已成为PICU脓毒血症的主要致病菌,且对常用的多数β-内酰胺类药物耐药。铜绿假单胞菌所致脓毒血症病死率较高,且对多数药物耐药明显。前期经验性抗生素治疗,后期根据药敏结果合理应用抗菌药物是有效控制感染、降低病死率、改善预后的重要手段。 相似文献
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Purpose
The aims of this study were to determine the prevalence of hypophosphatemia and to discuss the clinical implications of hypophosphatemia in critically ill children.Materials and Methods
A retrospective review of the medical records of children admitted to the pediatric intensive care unit from December 2006 to December 2007 was conducted.Results
In 60.2% (n = 71) of the patients, any serum phosphorous level at admission and at the third day or seventh day after admission to pediatric intensive care unit was in hypophosphatemic range. Sepsis was present in 22.9% (n = 27) of the children studied and was associated with hypophosphatemia (P = .02). Hypophosphatemia was also associated with use of furosemide (P = .04), use of steroid (P = .04), use of β2 agonist (P = .026), and use of an H2 blocker (P = .004). There was a significant association between hypophosphatemia and the rate to attain target caloric requirements by enteral route (P = .007). The median time to attain target caloric requirements by enteral route was 2.9 ± 1.9 (0.2-10) days in the normophosphatemic group and 4.4 ± 2.8 (0.3-12) days in the hypophosphatemic group. In the multiple regression model, solely the rate to attain the target caloric requirements by enteral route demonstrated independent association with hypophosphatemia (P = .006; β = .27; 95% confidence interval, 0.02-0.09). Significant association was found between hypophosphatemia and the duration of mechanical ventilation and between hypophosphatemia and pediatric intensive care unit length of stay (P = .02 and P = .001, respectively).Conclusions
Critically ill pediatric patients are prone to hypophosphatemia, especially if they cannot be fed early by enteral route. Hypophosphatemia is associated with an increased duration of mechanical ventilation and increased length of stay in the pediatric intensive care unit, suggesting that active repletion might improve these parameters. 相似文献116.
Alireza Eskandarifar Mohammad Aziz Rasouli Majid Mansouri Samaneh Moosavi Ahmad Fotoohi 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2019,13(1):464-466
IntroductionHypoglycemia in critically ill infants is a frequent metabolic disorder which is often due to defective glucose homeostasis. If not recognized annotated early, it can result in severe neurological damage with high mortality and morbidity. Today, glucometer is recommended for fast measuring blood glucose. The aim of this study was to evaluate the accuracy of glucometer for early diagnosis of hypoglycemia in the acutely ill infant.Materials and methodsThis study evaluates 130 critically ill infants less than 1year of age who were admitted to Besat hospital – Sanandaj – IRAN. Blood sugar was measured by standard serum method (glucose oxidase) and glucometer reagent strip.ResultsThe overall means of blood sugar were 115.6 ± 1.75 with serum method and 119.1 ± 1.56 with glucometer method. The rates of sensitivity, specificity, positive predictive value and negative predictive value with glucometer method and with serum glucose method were 72%, 53%, 62%, and 77% respectively. The correlation between the two methods was significant (p < 0.001). Kappa statistics for the two methods was 42%.ConclusionsThe results showed that in general, glucometer may be appropriate for rapid screening in emergency situations and when frequent blood glucose monitoring is needed but it cannot be regarded as a very suitable and reliable tool for diagnosis of hypoglycemia in critically ill infants. 相似文献
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周嬛鹦 《中华现代护理杂志》2011,17(8):957-959
目的探讨植入式输液港在反复人住儿科重症监护室(PICU)患儿中应用的效果和护理法,以利于反复入住PICU患儿的救治,减少反复穿刺带来的痛苦和恐惧,减轻护士工作量和工作压力。方法经外科医生行锁骨下静脉植入上腔静脉,做好治疗期和非治疗期的维护。结果2例患儿目前顺利应用中,无并发症。结论植入式输液港作为永久性静脉通道使用方便、安全,不影响生活,提高患儿生存质量。 相似文献
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Erwin Ista Harma te Beest Joost van Rosmalen Matthijs de Hoog Dick Tibboel Babette van Beusekom Monique van Dijk 《Australian critical care》2018,31(5):266-273