ABSTRACT
No disponible
Subject(s)
Humans , Female , Infant , Cushing Syndrome/drug therapy , Etomidate/pharmacokinetics , Hypertension/complications , Hypokalemia/complications , Treatment Outcome , Adrenocorticotropic Hormone/analysisSubject(s)
Cushing Syndrome/drug therapy , Etomidate/therapeutic use , Hypertension/etiology , Hypokalemia/etiology , Adrenal Cortex/drug effects , Adrenal Cortex/metabolism , Adrenal Cortex/pathology , Cushing Syndrome/blood , Cushing Syndrome/complications , Cushing Syndrome/physiopathology , Disease Susceptibility , Escherichia coli Infections/complications , Etomidate/pharmacology , Fatal Outcome , Female , Humans , Hydrocortisone/blood , Hydrocortisone/metabolism , Hypertension/drug therapy , Hypertension/physiopathology , Immunocompromised Host , Infant , Labetalol/therapeutic use , Shock, Septic/complicationsABSTRACT
No disponible
Subject(s)
Humans , Male , Child , Hemoptysis/complications , Hemoptysis/diagnosis , Radiography, Thoracic/methods , Tomography, Emission-Computed/methods , Ventilation-Perfusion Ratio/physiology , First Aid/adverse effects , First Aid/methods , Asphyxia/therapy , Dyspnea/complications , Dyspnea/diagnosis , Hemorrhage/complications , Hypoxia/complications , Foreign Bodies/complications , Airway Obstruction/therapyABSTRACT
Acute hemorrhage is a sometimes serious complication that may arise in patients admitted to the intensive care unit with coagulopathy. The usual therapy is transfusion of blood components: fresh frozen plasma, platelets, fibrinogen, red cell concentrate and vitamin K. Tolerance or response can sometimes be poor. We present three patients aged 18 months, 4.5 and 10 years who suffered an acute episode of severe, life-threatening hemorrhage in the course of meningococcal sepsis (gastric hemorrhage), myelomonocytic leukemia (during splenectomy) and in the postoperative period after cardiovascular surgery. Traditional therapy was ineffective and activated factor VII was administered at doses of 50-70 microg/kg, with rapid control of bleeding.
Subject(s)
Factor VIIa/therapeutic use , Gastrointestinal Hemorrhage/drug therapy , Hemorrhagic Septicemia/drug therapy , Postoperative Hemorrhage/drug therapy , Acute Disease , Cardiac Surgical Procedures , Child, Preschool , Drug Administration Schedule , Factor VIIa/administration & dosage , Female , Gastrointestinal Hemorrhage/complications , Hemorrhagic Septicemia/microbiology , Hemostasis , Humans , Infant , Male , Meningococcal Infections/complications , Severity of Illness Index , Shock, Septic , Splenectomy , Thrombocytopenia/etiology , Treatment OutcomeABSTRACT
La hemorragia aguda es una complicación, en ocasiones grave, que puede presentarse en pacientes con coagulopatía, ingresados en la unidad de cuidados intensivos pediátricos (UCIP). El tratamiento habitual es transfusión de hemoderivados: plasma fresco congelado, plaquetas, fibrinógeno, concentrado de hematíes y vitamina K, siendo a veces la tolerancia o la respuesta al mismo mala. Se presentan 3 pacientes con edades de 18 meses, 4,5 y 10 años que tuvieron un episodio agudo de hemorragia grave con compromiso vital en el curso de una sepsis meningocócica (hemorragia digestiva), leucemia mielomonocítica (durante la realización de esplenectomía) y postoperatorio de cirugía cardiovascular. Tras el fracaso del tratamiento convencional se administró factor VII activado a dosis entre 50-70 mg/kg con lo que se controló rápidamente la sintomatología de hemorragia
Acute hemorrhage is a sometimes serious complication that may arise in patients admitted to the intensive care unit with coagulopathy. The usual therapy is transfusion of blood components: fresh frozen plasma, platelets, fibrinogen, red cell concentrate and vitamin K. Tolerance or response can sometimes be poor. We present three patients aged 18 months, 4.5 and 10 years who suffered an acute episode of severe, life-threatening hemorrhage in the course of meningococcal sepsis (gastric hemorrhage), myelomonocytic leukemia (during splenectomy) and in the postoperative period after cardiovascular surgery. Traditional therapy was ineffective and activated factor VII was administered at doses of 50-70 mg/kg, with rapid control of bleedin
