The effect of cyanosis on active clotting time during diagnostic catheterization.

INTRODUCTION: Cardiac catheterization is a common procedure which needs a careful coagulation monitoring. In our study, we aimed to find factors influencing active clotting time (ACT) following heparin therapy. METHODS: ACT of 71 patients who were scheduled to undergo transcutaneous diagnostic catheterization and angiography were measured at baseline, 2 and 60 minutes after 50 IU/kg heparin loading. ACT in two groups of patients (cyanotic and non-cyanotic) was compared. All data were analyzed with Wilcoxon, Mann-Whitney test and Pearson in SPSS 16, P value less than 0.05 was considered significant. RESULTS: ACT following heparin at 2nd and 60th minutes was not significantly different in cyanotic and non-cyanotic groups. At 60th minute following heparin administration, ACT decreased more dramatically in older children. CONCLUSION: Cyanosis does not affect ACT measures following heparin treatment. Moreover, after 60 minutes, heparin efficacy (ACT values) decreased more with increase in patients' age.

Therapeutic effect of insulin in reducing critical illness; polyneuropathy and myopathy in the pediatric intensive care unit.

OBJECTIVE: Hyperglycemia may occur in the patients affected by any kind of critical illness. This complication makes an adverse effect on the clinical outcome of these patients by causing polyneuropathy and myopathy. It has been recently shown that treatment of hyperglycemia with insulin administration significantly reduces the prevalence of critical illness polyneuropathy and myopathy (CIPNM) and on the other hand reduces the demand for long-term mechanical ventilation in the patients admitted to the ICU for more than 1 week. The aim of this study was to determine the therapeutic effect of insulin in reducing the incidence of CIPNM in the pediatric intensive care unit (PICU). MATERIALS & METHODS: In this study, we recruited 30 patients admitted to the PICU of Tabriz Pediatric Hospital. The incidence of CIPNM following hyperglycemia was evaluated in these patients. The patients were categorized into two groups. In the case group, blood sugar was controlled in the range of 140-180mg/dl by administration of 0.05 unit per kilogram body weight of insulin as drip protocol in an hour and in the control group, placebo was used. Consequently, the incidence of CIPNM, duration of PICU and duration of mechanical ventilation were compared between the two groups. RESULTS: The incidence of CIPNM and duration of PICU stay and mechanical ventilation were significantly reduced in the patients treated with insulin compared to the control group. CONCLUSION: This study shows that blood sugar control decreases the incidence of CIPNM.