High-Dose Voriconazole in A Critically Ill Pediatric Patient With Neuroblastoma

2008 ◽  
Vol PAP ◽  
Author(s):  
Jan-Willem C. Alffenaar ◽  
Rienus A. Doedens ◽  
Ellis Groninger ◽  
Jos G. W. Kosterink
Keyword(s):  
Critically Ill ◽  
Pediatric Patient ◽  
High Dose

scholarly journals Nonepileptic Myoclonus in COVID-19: Case Report

2021 ◽  
pp. 194187442110043
Author(s):  
Henly Hewan ◽  
Annie Yang ◽  
Aparna Vaddiparti ◽  
Benison Keung
Keyword(s):  
Case Report ◽  
Critically Ill ◽  
Recovery Phase ◽  
Critically Ill Patient ◽  
High Dose ◽  
The Novel ◽  
Neurological Manifestations ◽  
Immune Mediated ◽  
Novel Coronavirus ◽  
Post Infectious

In late 2019, the novel coronavirus, SARS-CoV-2, and the disease it causes, COVID-19, was identified. Since then many different neurological manifestations of COVID-19 have been well reported. Movement abnormalities have been rarely described. We report here a critically ill patient with COVID-19 who developed generalized myoclonus during the recovery phase of the infection. Myoclonus was associated with cyclical fevers and decreased alertness. Movements were refractory to conventional anti-epileptic therapies. There was concern that myoclonus could be part of a post-infectious immune-mediated syndrome. The patient improved fully with a 4-day course of high-dose steroids. Our experience highlights a rare, generalized myoclonus syndrome associated with COVID-19 that may be immune-mediated and is responsive to treatment.

scholarly journals Impact of high dose prophylactic anticoagulation in critically ill patients with COVID-19 pneumonia

CHEST Journal ◽  
2021 ◽  
Author(s):  
Charles Tacquard ◽  
Alexandre Mansour ◽  
Alexandre Godon ◽  
Julien Godet ◽  
Julien Poissy ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
High Dose ◽  
Prophylactic Anticoagulation

scholarly journals Hypersensitivity reaction to high-dose methotrexate and successful rechallenge in a pediatric patient with osteosarcoma

2013 ◽  
Vol 61 (2) ◽  
pp. 373-375 ◽  
Author(s):  
Jeffrey R. Scott ◽  
Deborah A. Ward ◽  
Kristine R. Crews ◽  
John C. Panetta ◽  
Fariba Navid
Keyword(s):  
Hypersensitivity Reaction ◽  
Pediatric Patient ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Dose Methotrexate

scholarly journals High-dose vitamin C infusion for the treatment of critically ill COVID-19

2020 ◽  
Author(s):  
Jing Zhang ◽  
Xin Rao ◽  
Yiming Li ◽  
Yuan Zhu ◽  
Fang Liu ◽  
...  
Keyword(s):  
Placebo Group ◽  
Vitamin C ◽  
Critically Ill ◽  
Day Treatment ◽  
Invasive Mechanical Ventilation ◽  
Controlled Clinical Trial ◽  
High Dose ◽  
C 50 ◽  
Intravenous Vitamin ◽  
High Dose Vitamin

Abstract BackgroundNo specific medication has been proven effective for the treatment of patients with severe coronavirus disease 2019 (COVID-19). Here, we tested whether high-dose vitamin C infusion was effective for severe COVID-19.MethodsThis randomized, controlled clinical trial was performed at 3 hospitals in Hubei, China. Patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the ICU were randomly assigned in as 1:1 ratio to either the high-dose intravenous vitamin C (HDIVC) or the placebo. HDIVC group received 12 g of vitamin C/50 ml every 12 hours for 7 days at a rate of 12 ml/hour, and the placebo group received bacteriostatic water for injection in the same way. The primary outcome was invasive mechanical ventilation-free days in 28 days(IMVFD28). Secondary outcomes were 28-day mortality, organ failure, and inflammation progression.ResultsFifty-four critical COVID-19 patients were ultimately recruited. There was no difference in IMVFD28 between two groups. During the 7-day treatment period, patients in the HDIVC group had a steady rise in the PaO2/FiO2 (day 7: 229 vs. 151 mmHg, 95% CI 33 to 122, P = 0.01). Patients with SOFA scores ≥ 3 in the HDIVC group exhibited a significant reduction in 28-day mortality (P = 0.05) in univariate survival analysis. IL-6 in the VC group was lower than that in the placebo group (19.42 vs. 158.00; 95% CI -301.72 to -29.79; P = 0.04) on day 7.ConclusionThe addition of HDIVC may provide a protective clinical effect without any adverse events in critically ill patients with COVID-19.Clinicaltrial.gov identifer: NCT04264533

scholarly journals The effect of high-dose parenteral sodium selenite in critically ill patients following sepsis: A clinical and mechanistic study

2017 ◽  
Vol 21 (5) ◽  
pp. 287-293 ◽  
Author(s):  
Mohammad Abdollahi ◽  
Legese Chelkeba ◽  
Arezoo Ahmadi ◽  
Atabak Najafi ◽  
Mohammad Hosein Ghadimi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Sodium Selenite ◽  
Mechanistic Study ◽  
High Dose

Grade of sedation in the critically ill pediatric patient and its correlation with sociodemographic and clinical variables. Multicentre COSAIP study

2021 ◽  
Author(s):  
A. Bosch-Alcaraz ◽  
S. Alcolea-Monge ◽  
R. Fernández Lorenzo ◽  
P. Luna-Castaño ◽  
S. Belda-Hofheinz ◽  
...  
Keyword(s):  
Critically Ill ◽  
Pediatric Patient ◽  
Clinical Variables

scholarly journals Dosing of thromboprophylaxis and mortality in critically ill COVID-19 patients

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Sandra Jonmarker ◽  
Jacob Hollenberg ◽  
Martin Dahlberg ◽  
Otto Stackelberg ◽  
Jacob Litorell ◽  
...  
Keyword(s):  
Body Weight ◽  
Confidence Intervals ◽  
Critically Ill ◽  
Low Dose ◽  
Cox Proportional Hazards ◽  
High Dose ◽  
Thromboembolic Events ◽  
Risk Of Death ◽  
Dosing Strategy ◽  
Medium Dose

Abstract Background A substantial proportion of critically ill COVID-19 patients develop thromboembolic complications, but it is unclear whether higher doses of thromboprophylaxis are associated with lower mortality rates. The purpose of the study was to evaluate the association between initial dosing strategy of thromboprophylaxis in critically ill COVID-19 patients and the risk of death, thromboembolism, and bleeding. Method In this retrospective study, all critically ill COVID-19 patients admitted to two intensive care units in March and April 2020 were eligible. Patients were categorized into three groups according to initial daily dose of thromboprophylaxis: low (2500–4500 IU tinzaparin or 2500–5000 IU dalteparin), medium (> 4500 IU but < 175 IU/kilogram, kg, of body weight tinzaparin or > 5000 IU but < 200 IU/kg of body weight dalteparin), and high dose (≥ 175 IU/kg of body weight tinzaparin or ≥ 200 IU/kg of body weight dalteparin). Thromboprophylaxis dosage was based on local standardized recommendations, not on degree of critical illness or risk of thrombosis. Cox proportional hazards regression was used to estimate hazard ratios with corresponding 95% confidence intervals of death within 28 days from ICU admission. Multivariable models were adjusted for sex, age, body mass index, Simplified Acute Physiology Score III, invasive respiratory support, and initial dosing strategy of thromboprophylaxis. Results A total of 152 patients were included: 67 received low-, 48 medium-, and 37 high-dose thromboprophylaxis. Baseline characteristics did not differ between groups. For patients who received high-dose prophylaxis, mortality was lower (13.5%) compared to those who received medium dose (25.0%) or low dose (38.8%), p = 0.02. The hazard ratio of death was 0.33 (95% confidence intervals 0.13–0.87) among those who received high dose, and 0.88 (95% confidence intervals 0.43–1.83) among those who received medium dose, as compared to those who received low-dose thromboprophylaxis. There were fewer thromboembolic events in the high (2.7%) vs medium (18.8%) and low-dose thromboprophylaxis (17.9%) groups, p = 0.04. Conclusions Among critically ill COVID-19 patients with respiratory failure, high-dose thromboprophylaxis was associated with a lower risk of death and a lower cumulative incidence of thromboembolic events compared with lower doses. Trial registration Clinicaltrials.gov NCT04412304 June 2, 2020, retrospectively registered.

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