Successful Right Atrium-Pulmonary Artery ECMO in an Infant With Severe Necrotizing Pneumonia and Bilateral Bronchopleural Fistula

We report an infant with necrotizing pnuemonia and bilateralbroncho pleural fistula, who failed on conventional and highfrequency ventilation and was managed successfully on Veno-venous Extra Corporeal Membrane Oxygenator (V-V ECMO)with a unique configuration for 12 days, and weaned offsuccessfully.

Serum Magnesium in Overweight Children.

Objective: To determine whether overweight children and adolescents have lower serum concentration and lower dietary intake of magnesium compared to those with normal weight; and to study the correlation of serum magnesium levels with components of metabolic syndrome in children and adolescents. Design: Cross-sectional, comparative study. Setting: General/Pediatric Endocrinolgy OPD tertiary care medical centre. Study done from July 2007 to March 2009 Participants: 55 overweight and 53 normal weight children and adolescents aged 4 years to 14 years. Methods: We compared fasting levels of serum magnesium, insulin, glucose, total and HDL-cholesterol, triglycerides and dietary magnesium intake. Results: The serum magnesium levels were significantly lower in overweight (2.12 ± 0.33 mg/dL) compared to normal weight group (2.56 ± 0.24 mg/dL, P<0.001), while the dietary intake of magnesium (adjusted for calorie intake) was higher in overweight group (0.20 ± 0.06 mg/ kcal) compared to normal weight (0.17 ± 0.05 mg/kcal; P= 0.005). Serum magnesium levels were inversely correlated with body mass index, systolic blood pressure, diastolic blood pressure, waist circumference and fasting insulin levels. Conclusions: Serum magnesium levels were significantly lower in overweight children compared to those with normal weight in spite of a higher dietary intake.

Inflicted neuro-trauma in infancy.

Two infants with non-accidental inflicted neuro-trauma are reported. One presented with sudden onset lethargy, respiratory difficulty and unexplained seizures. There were bilateral retinal bleeds and extradural hemmorage. Other was a well thriving child who had 2 seizures and was noted to lack visual fixation. Retinal hemorrhages and chronic subdural and intraparenchymal hemorrhages were subsequently discovered. We highlight the importance of suspecting child abuse in infants with sudden unexplained unresponsiveness, seizures or respiratory difficulty and the unusual occurrence of extradual hemorrhage.

Blood and blood component therapy in neonates.

Blood component therapy is a very common intervention practiced in newborns; nearly 85% of extremely low birth weight (ELBW) babies get transfusions during their hospital stay. However, there are no set guidelines for transfusion of blood component therapy in newborns. This protocol includes available types of blood components, their methods of preparation, indications and side effects of transfusion, in relation to newborns.