Association between duration of fever before treatment and intravenous immunoglobulin resistance in Kawasaki disease / 中国当代儿科杂志

OBJECTIVES@#To examine the association between duration of fever before intravenous immunoglobulin (IVIG) treatment and IVIG resistance in children with Kawasaki disease (KD).@*METHODS@#A retrospective analysis was performed on the medical data of 317 children with KD who were admitted from January 2018 to December 2020. According to the duration of fever before IVIG treatment, they were divided into two groups: short fever duration group (≤4 days) with 92 children and long fever duration group (>4 days) with 225 children. According to the presence or absence of IVIG resistance, each group was further divided into a drug-resistance group and a non-drug-resistance group. Baseline data and laboratory results were compared between groups. A multivariate logistic regression analysis was used to identify the influencing factors for IVIG resistance.@*RESULTS@#In the short fever duration group, 19 children (20.7%) had IVIG resistance and 5 children (5.4%) had coronary artery aneurysm, and in the long fever duration group, 22 children (9.8%) had IVIG resistance and 19 children (8.4%) had coronary artery aneurysm, suggesting that the short fever duration group had a significantly higher rate of IVIG resistance than the long fever duration group (P<0.05), while there was no significant difference in the incidence rate of coronary artery aneurysm between the two groups (P>0.05). In the short fever duration group, compared with the children without drug resistance, the children with drug resistance had a significantly lower level of blood sodium and significantly higher levels of procalcitonin, C-reactive protein, and N-terminal B-type natriuretic peptide before treatment (P<0.05). In the long fever duration group, the children with drug resistance had significantly lower levels of blood sodium and creatine kinase before treatment than those without drug resistance (P<0.05). The multivariate logistic regression analysis showed that a reduction in blood sodium level was associated with IVIG resistance in the long fever duration group (P<0.05).@*CONCLUSIONS@#IVIG resistance in children with KD varies with the duration of fever before treatment. A reduction in blood sodium is associated with IVIG resistance in KD children with a duration of fever of >4 days before treatment.

Transjugular closure of atrial septal defect under transesophageal echocardiography guidance in infants:A report of 13 cases / 中国实用儿科杂志

OBJECTIVE: To explore the availability of transcatheter closure of atrial septal defect(ASD)in infants guided by transesophageal echocardiography(TEE). METHODS: The clinical data of 13 infants(under one year old)with ASD who underwent transcatheter closure via right jugular vein through adjustable curved sheath under guidance of TEE from June 2015 to March 2018 in Qingdao Women and Children's Hospital were analyzed retrospectively. The operation effect,time and complications were evaluated. RESULTS: All 13 infants were successfully occluded. TEE can accurately guide the establishment of the delivery track. The operation time was(27.2±15.1)minutes. All patients had satisfactory occluder shape and fixed position,without such complications as arrhythmia,hemolysis,embolism,infection,pneumothorax,hemothorax or vessel injury.CONCLUSION: TEE-guided transjugular closure of ASD is a feasible method,which can avoid surgical risks and vessel complications in young and low-bodyweight infants;Meanwhile,the potential radiation damage can be avoided.