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Ramin Zare Mahmoudabadi, Behzad Haghighi Aski, Ali Manafi Anari, Zahra Serati,
Volume 5, Issue 2 (11-2019)
Abstract

Backgrounds: Ventilator-associated pneumonia (VAP) is the most widespread infection among individuals hospitalized in intensive care units leading to high mortality and morbidity as well as a high cost burden. We aimed to compare the bacterial strains obtained from respiratory secretions using the mini-BAL technique within four days of intubation in children admitted to PICU.
Methods: This cross-sectional study was conducted on all consecutive children who were admitted to PICU ward at Ali-Asghar referral children hospital in Tehran in 2018 with that assessed for qualitative and quantitative analysis of respiratory secretions by Mini-BAL due to suspicion to VAP.
Results: In total, 53 children suspected to VAP were included into the assay. Assessing the respiratory secretion at the first day of intubation found two positive cultures for klebsiella strain indicating an infection rate of 3.7%. Assessing the results of bacterial cultures at the fourth days of intubation revealed 18 positive cultures for different species including klebsiella in 7 cases, pseudomonas in 3 cases, Acinetobacter in 2 cases, Serratia in 1 case, Alcaligenes in 1 case, Enterobacter in 1 case, Enterococcus in 1 case, Escherichia Coli in 1 case and candida albicans in 1 case yielding an overall VAP rate of 34.0%.
Conclusion: VAP is a common event among children who are intubated in PICU and the likelihood of this complication can be raised over time from intubation as about one-third of our assessed children suffered from VAP at the fourth day after intubation. The most common strains affecting such children include klebsiella followed by pseudomonas and Acinetobacter.

Roya Isa Tafreshi ,
Volume 6, Issue 2 (8-2020)
Abstract

Tachycardia is common in the pediatric age group. The most commonly seen arrhythmias in children are sinus tachycardia. However, supraventricular tachycardia is the most common tachyarrhythmia that necessitates treatment. Ventricular tachycardia is rare in healthy children but may be associated with sudden cardiac death.  The important risk factors that predispose children for arrhythmias include congenital heart disease or previous cardiac surgery. Although hemodynamic instability, electrolyte and acid-base imbalance and the use of vasoactive drugs also predispose children to various types of arrhythmias. Clinical presentation is dependent upon age .The most common symptoms include palpitations, chest pain, abdominal pain in children or irritability, lethargy and poor feeding in infants. Emergency management of common tachycardia depends on the patient's clinical status. The purpose of this article is to provide a summary of diagnostic and acute management guidelines of the most common types of arrhythmias seen in children with structurally normal hearts.


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