Abstract：
BACKGROUND/PURPOSE:Serum lactate measurement has a predictive value in adult trauma. To date, there has been no prospective analysis of the predictive value of admission serum lactate in pediatric trauma. METHODS:Admission serum lactate was prospectively measured over a two year period on all children under age 15 years who met trauma alert criteria at an urban Level 1 trauma center. Elevated serum lactate (>2.0 mmol/L) was correlated with Injury Severity Scores (ISS), injury types, and hospital outcomes. RESULTS:A total of 277 injured children with admission lactate measurements were evaluated. Patients with elevated lactate had higher mean ISS than those with normal lactate (12.8 vs. 5.1, p<0.01), and increased need for intubation, major procedures and ICU admission. Elevated lactate was associated with low specificity (54.4%), moderate sensitivity (86.7%) and high negative predictive value (94.5%) for detecting injury (ISS>15). Lactate measurements over 4.7 mmol/L were highly specific (95.8%) for injury. CONCLUSIONS:Elevated admission venous lactate level is associated with injury and outcomes, but lacks adequate sensitivity and specificity. Lactate over 4.7 mmol/L is strongly suggestive of severe injury, while lactate below 2.0 mmol/L is reassuring for not having injury. Lactates between 2.0 and 4.7 mmol/L remain indeterminate in predictive potential for injury or outcomes.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Ramanathan R,Parrish DW,Hartwich JE,Haynes JHdoi
10.1016/j.jpedsurg.2014.08.013subject
Has Abstractpub_date
2015-04-01 00:00:00pages
598-603issue
4eissn
0022-3468issn
1531-5037pii
S0022-3468(14)00496-5journal_volume
50pub_type
临床试验,杂志文章abstract：AIM:Even with prompt diagnosis and treatment, testicular torsion may lead to infertility and atrophy after testicular salvage. The aims of this study were to investigate the long-term protective effects of short-interval postconditioning on testicular atrophy and to optimize the reperfusion period. MATERIALS AND METHO...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.10.070
更新日期：2012-04-01 00:00:00
abstract：:The prime goal in the management of infants with short gut syndrome is the smooth transition from total parenteral alimentation to total gastrointestinal alimentation. Such transition is dependent upon early feeding to actively promote the intestinal mucosal hyperplasia that is the key to eventual oral alimentation. A...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(81)80678-1
更新日期：1981-06-01 00:00:00
abstract：BACKGROUND:The ideal colostomy type for patients with anorectal malformations (ARM) is undetermined. We performed a systematic review and meta-analysis of short-term complications comparing loop and divided colostomies. METHODS:After review registration (PROSPERO: CRD42016036481), multiple databases were searched for ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jpedsurg.2017.01.044
更新日期：2017-05-01 00:00:00
abstract：PURPOSE:The aim of this study was to investigate the prenatal courses and management of abdominal surgical diseases. METHODS:Of the 327 patients registered with our fetal treatment board since March 2002, 83 fetuses referred to the surgical department were enrolled for the current study. The prenatal diagnosis, sequen...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.08.039
更新日期：2004-12-01 00:00:00
abstract：:Isolated sternal clefts are rare congenital anomalies. Complete clefts are rarer still with only 23 cases being reported. We present an adolescent girl with a complete sternal cleft. The cleft was treated with autologous anterior perichondrial flaps and pectoralis advancement flaps. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.09.019
更新日期：2009-12-01 00:00:00
abstract：PURPOSE:Initial Children's Oncology Group (COG) management for Wilms' tumor (WT) consists of primary nephroureterectomy with lymph node sampling. While this provides accurate staging to define further treatment, it may result in intraoperative spill (IOS), which is associated with higher recurrence rates and therefore ...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/j.jpedsurg.2012.10.015
更新日期：2013-01-01 00:00:00
abstract：:A new extracorporeal membrane oxygenation (ECMO) circuit using air-driven artificial hearts as a blood pump was first applied on a newborn with congenital diaphragmatic hernia. ECMO was continued for 67 hours 36 minutes with no mechanical trouble. Since the artificial hearts changed their output automatically in propo...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90334-h
更新日期：1993-06-01 00:00:00
abstract：:An 11-day-old neonate presents with worsening nonbilious emesis and radiographic findings suggestive of pyloric stenosis. Using a laparoscopic approach, a slightly asymmetric and hypertrophied pylorus was visualized. The unusual age of presentation and appearance of the pylorus led to the decision to perform an open e...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.02.045
更新日期：2011-07-01 00:00:00
abstract：PURPOSE:The aim of this study was to clarify the pathogenesis of intestinal neuronal dysplasia (IND). METHODS:The bowel habits of 36 postoperative HD patients were assessed retrospectively. Twenty-five had no complaints. Seven had persistent enterocolitis and were the focus of our study. They were divided into group A...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2003.10.008
更新日期：2004-02-01 00:00:00
abstract：PURPOSE:The purpose of this report is to detail the nutritional sequelae seen in survivors of congenital diaphragmatic hernia (CDH) followed in a multidisciplinary clinic. METHODS:Data on 121 surviving CDH patients seen between 1990 and 2000 were collected. Regression analysis was used to determine the impact of facto...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2001.25746
更新日期：2001-08-01 00:00:00
abstract：BACKGROUND:The safety of the laparoscopic treatment of intestinal malrotation remains controversial. This study compared the outcomes of laparoscopic and open surgical treatment of intestinal malrotation. METHODS:A multicentric retrospective study included pediatric cases of intestinal malrotation operated on between ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2020.08.014
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND/PURPOSE:Treatment of chylous leaks using enteral feeds supplemented with medium chain triglycerides (MCT) is used widely but often ineffective. Few studies have examined the conventional dogma that MCTs and simple sugars are absorbed directly via the portal system. This study tests the hypothesis that signif...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(99)90225-7
更新日期：1999-01-01 00:00:00
abstract：PURPOSE:The signals that govern the upregulation of nutrient absorption (adaptation) after intestinal resection are not well understood. A Gastric Roux-en-Y bypass (GRYB) model was used to isolate the relative contributions of direct mucosal stimulation by nutrients, biliary-pancreatic secretions, and systemic enteric ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.02.036
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND/PURPOSE:Primary gastric tumors are rare in infancy and childhood. Because of the infrequent occurrence of these tumors, the clinician may be unfamiliar with optimal management strategies. We review our experience over the past 54 years and the current literature. METHODS:During the period extending from 195...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.11.016
更新日期：2008-08-01 00:00:00
abstract：:Reduced-size liver transplantation has been recognized as a powerful modality in alleviating the global donor shortage in pediatric liver transplantation. We describe, for the first time, a technique for revascularizing reduced-size grafts which has not been patterned after adult revascularization techniques. This rev...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90698-k
更新日期：1993-07-01 00:00:00
abstract：:The case of a 13-year-old girl with primary Epstein-Barr virus (EBV) infection and concomitant cholestatic hepatitis, which initially presented as acute acalculous cholecystitis (AAC), is described. The diagnosis of AAC was documented by clinical and ultrasonographic criteria, whereas acute EBV infection was confirmed...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.11.004
更新日期：2007-01-01 00:00:00
abstract：PURPOSE:We examined the effectiveness of a postoperative ruptured appendicitis protocol that eliminated Pseudomonas coverage and based the duration of IV antibiotic treatment and length of hospital stay on the patient's clinical response. METHODS:In our new protocol, IV antibiotics were administered until the patient ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2014.09.012
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:If creating an obstructive uropathy early in glomerulogenesis produces MCDK (Multicystic Dysplastic Kidney), then a very early obstruction may produce Potter's Syndrome (PS) with oligohydramnios. METHODS:Fetal lambs at 50 days' gestation underwent urethral and urachal ligation using fine SILASTIC (Dow Corni...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2000.18305
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND:Achalasia is a primary esophageal motility disorder characterized by aperistalsis of the esophagus and failed relaxation of the lower esophageal sphincter that presents rarely in childhood. The peroral endoscopic myotomy (POEM) procedure is an emerging treatment for achalasia in adults that has recently been...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.07.023
更新日期：2018-08-01 00:00:00
abstract：:Acute appendicitis is the most frequent urgent abdominal surgical pathology in children. Therapeutic decisions in patients who have undergone an appendectomy are made based on the macroscopic findings at the moment of surgery. There is high variability between surgical and histopathological findings. METHOD:Concordan...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.09.025
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND/PURPOSE:This study was aimed at applying fetal tissue engineering to chest wall reconstruction. METHODS:Fetal lambs underwent harvest of elastic and hyaline cartilage specimens. Once expanded in vitro, fetal chondrocytes were seeded onto synthetic scaffolds, which then were placed in a bioreactor. After bir...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(03)00265-3
更新日期：2003-08-01 00:00:00
abstract：:An instance of fibrous hamartoma of infancy (FHI) in the perianal region of an 8-mo-old infant, a hitherto unreported location, is described. The majority of the reported cases occur in the torso and upper extremities. The differential diagnostic features which aid differentiating FHI from other conditions is discusse...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(79)80582-5
更新日期：1979-02-01 00:00:00
abstract：IMPORTANCE:Telemedicine is an emerging strategy for healthcare delivery that has the potential to expand access, optimize efficiency, minimize cost, and enhance patient satisfaction. OBJECTIVE:To review the current spectrum, potential strategies, and implementation process of telemedicine in pediatric surgery. DESIGN...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2018.04.038
更新日期：2019-03-01 00:00:00
abstract：PURPOSE:Management guidelines for infants with chylothorax lack substantial evidence. We sought to identify variables that impact outcomes in these patients in order to develop an evidence-based management algorithm. METHODS:We retrospectively reviewed the medical records of all infants diagnosed with chylothorax from...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.03.010
更新日期：2017-06-01 00:00:00
abstract：BACKGROUND:The treatment of incidentally encountered asymptomatic Meckel diverticulum (MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions. METHODS:Patients who underwent MD resection at a si...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.08.066
更新日期：2016-07-01 00:00:00
abstract：:This study used retrospective review of patients with critical airway due to compression by an anterior mediastinal mass treated at a single pediatric teaching institution. Diagnostic workup is reviewed with a focus on diagnostic biopsy. Algorithm for streamlining the choice of biopsy technique and minimizing invasive...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.02.083
更新日期：2008-11-01 00:00:00
abstract：PURPOSE:Previous studies comparing extracorporeal membrane oxygenation (ECMO) modality for congenital diaphragmatic hernia (CDH) have not accounted for confounding by indication. We therefore hypothesized that using a propensity score (PS) approach to account for selection bias may identify outcome differences based on...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2018.06.003
更新日期：2018-11-01 00:00:00
abstract：BACKGROUND:Perioperative hypothermia has been shown to increase surgical site infection (SSI) rates in adults. We sought to characterize whether intraoperative hypothermia or hyperthermia is associated with postoperative infections in infants. METHODS:We conducted a retrospective review of patients ≤6 months old who u...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2019.09.060
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND/PURPOSE:Closure of abdominal wall defects in children poses a challenge for pediatric surgeons. We describe a technique using tissue expanders placed either intraperitoneally or in the abdominal wall to aid in the reconstruction of a variety of complex abdominal wall defects. METHODS:The tissue expanders ar...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.11.020
更新日期：2011-02-01 00:00:00
abstract：:Postoperative pain control (PPC) in children is a difficult management problem. Systemic narcotics often result in respiratory depression, while nonnarcotic analgesics are associated with inconsistent PPC. This report reviews a 29-month (January 1989 through July 1991) experience with 174 children (aged < 18 years) wh...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(93)90616-s
更新日期：1993-04-01 00:00:00
