Serum levels of the cold stress hormones FGF21 and GDF-15 after cardiac arrest in infants and children enrolled in single center therapeutic hypothermia clinical trials

OBJECTIVE: TO provide a comprehensive review of warfarin use in infants and children, including recommendations for appropriate dosage and monitoring parameters. DATA SOURCES: A MEDLINE search (1966-1995) was used to identify pertinent English-language articles in the medical literature. The key search term was warfarin. Additional material was obtained from references cited in articles retrieved through MEDLINE. STUDY SELECTION: All articles involving children younger than 18 years were evaluated. In addition, articles on the pharmacokinetics and pharmacodynamics in adults, adverse effects, and drug interactions were included. DATA EXTRACTION: Material selected for review included clinical trials, case reports, and surveys of practice. DATA SYNTHESIS: Warfarin has been used as prophylactic therapy in children with prosthetic cardiac valves as well as for prevention of thromboembolic complications associated with autoimmune disorders and protein C or protein S deficiency. Warfarin also has been used to prevent embolization in children with deep-vein thrombosis or clots in central venous catheters. According to the literature, an initial dosage of 0.1 mg/kg/d should provide anticoagulation without significant adverse effects. As in adults, dosing should be adjusted to achieve a target international normalized ratio (INR). Although the target range in children is not well established, INR values of 1.5–3 are recommended for most patients. Higher values have been used in children with prosthetic cardiac valves and hereditary clotting disorders. CONCLUSIONS: Due to its infrequent use, there is limited information on the effects of warfarin in children. Basic guidelines for initiating and monitoring warfarin were developed by using data gathered from clinical trials, retrospective reviews, case series, and surveys of practice.

Download Full-text

FREQUENCY OF CARDIAC ARREST ASSOCIATED WITH ANESTHESIA IN INFANTS AND CHILDREN

PEDIATRICS ◽

10.1542/peds.28.5.697 ◽

1961 ◽

Vol 28 (5) ◽

pp. 697-704 ◽

Cited By ~ 1

Author(s):

Herbert Rackow ◽

Ernest Salanitre ◽

Lynne T. Green

Keyword(s):

Cardiac Arrest ◽

Medical Center ◽

Infants And Children ◽

Total Incidence ◽

In Infants And Children

At the Columbia-Presbyterian Medical Center, infants less than 1 year of age have a frequency of cardiac arrest during anesthesia, of 1:700, thought to be due to anesthesia, and a frequency of 1:600 attributed to anesthesia plus unknown causes. Children 1 to 12 years of age have a frequency of cardiac arrest during anesthesia of 1:2,300, thought to be due to anesthesia, and a frequency of 1:1,700 attributed to anesthesia plus unknown causes. The mortality and frequency of cardiac arrest during anesthesia in children (as defined by the number of deaths, and cardiac arrests due to anesthesia, in proportion to the incidence of anesthesia) cannot be determined in most previous reports because the total incidence of anesthesia for children was not presented. At the Columbia-Presbyterian Medical Center, the frequency of cardiac arrest during anesthesia in infants less than 1 year of age was found to be significantly higher than that in children 1 to 12 years of age or in adults 13 years of age or older. The rate for all children, infants plus children 1 to 12 years, is also significantly higher than the rate for adults. However, the rate of cardiac arrest during anesthesia in children 1 to 12 years of age was not significantly different from the rate in adults.

Download Full-text

Respiratory Syncytial Virus Immune Globulin Intravenous

Annals of Pharmacotherapy ◽

10.1177/106002809703100114 ◽

1997 ◽

Vol 31 (1) ◽

pp. 83-88 ◽

Cited By ~ 8

Author(s):

Todd L Wandstrat

Keyword(s):

Clinical Trials ◽

Respiratory Syncytial Virus ◽

Immune Globulin ◽

Data Extraction ◽

Safety Data ◽

Infants And Children ◽

Medline Search ◽

Study Selection ◽

Syncytial Virus ◽

In Infants And Children

OBJECTIVE: To review the clinical data detailing the use of respiratory syncytial virus immune globulin intravenous (RSV—IGIV) in infants and children. DATA SOURCES: A MEDLINE search (1990–1996) was used to identify all publications that dealt with RSV—IGIV clinical trials, pharmacology, and pharmacokinetics in infants and children. Bibliographies of articles were also used. STUDY SELECTION: All abstracts and clinical trials were reviewed. DATA EXTRACTION: Study design, population, efficacy, and safety data were retained. DATA SYNTHESIS: RSV—IGIV is an immunoglobulin product with serum neutralizing titers against RSV. It has been shown to reduce hospital stay, admissions, intensive care unit admissions, and mechanical ventilation days in infants and children with RSV pneumonia or bronchiolitis who are younger than 24 months of age and were born prematurely, or have bronchopulmonary dysplasia. RSV—IGIV is well tolerated by infants and children. CONCLUSIONS: RSV—IGIV is an effective prophylactic agent against serious RSV disease in select groups of infants and children.

Download Full-text