RESUMO
Objective To investigate the relationship between coagulation function and pediatric critical illness scores (PCIS) in children with severe pneumonia.Methods The PCIS were collected in 152 children with severe pneumonia (pneumonia group) admitted in our pediatric intensive care unit from Jan 2010 to Jul 2011,and 20 healthy children in the same period were selected as the healthy control group.The coagulation indicators of children in both groups were detected and the relationship between coagulation markers and severity of pneumonia was analyzed.Results There were significant differences in platelet count,fibrinogen,D-Dimer,soluble P-selectin between pneumonia group and healthy control goup [(185.74 ±116.26) × 109/L vs (287.10 ±90.01) × 109/L,(3.51 ±0.50) g/L vs (3.15 ±0.15) g/L,(1.39 ±2.18) μg/ml vs (0.36 ± 0.07) μ g/ml,(110.07 ± 83.47) ng/ml vs (33.74 ± 9.47) ng/ml,P ＜ 0.05].There were positive correlation between soluble P-selectin,D-Dimer and severity of disease and negative correlation between platelet count and severity of disease in children with severe pneumonia.Regression equation:y =1.154 +0.003 × soluble P-selectin + 0.089 × D-Dimer-0.001 × platelet count (P ＜ 0.05).As the children's critical condition getting worse,soluble P-selectin and D-Dimer levels increased (P ＜ 0.05).Hatelet count showed no significant difference between critical group and extremely critical group,which was significantly lower than that in non-critical group (P ＜ 0.05).Conclusion Soluble P-selectin,D-Dimer,and platelet count are associated with the severity of pneumonia.The children with severe pneumonia are easy to have coagulation disturbance.
RESUMO
Objective The aim of this randomized,double-blind,placebo-controlled trial was to evaluate the efficacy of the Saccharomyces boulardii (S.boulardii) power in preventing antibiotic-associated diarrhea (AAD) in hospitalized children with pneumonia.Methods Two hundred and forty-five hospitalized children with pneumonia were randomly divided into two groups,group 1 treated with antibiotics and S.boulardii power (n =104),and group 2 with antibiotics and placebo,along with S.boulardii power and zinc when suffered from diarrhea (n =141).All children received montmorillonite powder and fluid replacement therapy for diarrhea.The stool frequency and consistency were observed.Diarrhea incidence,diarrhea and pneumonia duration of treatment,and therapeutic effect were recorded.Results AAD is more prevalent in group 2 than in group 1 (P ＜0.05).A 55.7％ relative risk reduction in AAD was seen in group 1 compared with group 2 (RR =0.443,95％CI 0.233 ～ 0.845,P =0.012).Patients with preventive treatment of S.boulardii power in broup 1 had lower AAD incidence compared with those in group 2 (P ＜ 0.05).Both the diarrhea and pneumonia duration of treatment in group 1 were shorter than that in group 2(P =0.001 for diarrhea duration,P =0.030 for pneumonia duration,respectively).No drug related adverse reactions were found during the observation period.Conclusion Preventive use of S.boulardii power may effectively reduce the risk of AAD,improve therapeutic effect,and shorten hospital stays for hospitalized children with pneumonia.