Pediatrics open science最新文献

{"title":"Maintenance Fluids for Late Preterm and Term Infants: Is it Time to Reconsider?","authors":"Amanda J Chang, Daniel J York, Wenya Chen, Kaeli N Heidenreich, Malika D Shah","doi":"10.1542/pedsos.2024-000372","DOIUrl":"10.1542/pedsos.2024-000372","url":null,"abstract":"<p><strong>Background: </strong>Late preterm and term infants represent the majority of neonatal intensive care unit admissions globally, yet their fluid management remains underexplored.</p><p><strong>Methods: </strong>We conducted a retrospective medical record review of 174 infants 34 weeks' gestational age or older who received dextrose-containing fluids shortly after birth. These infants had 24-hour serum sodium measurements at our institution between April 2018 and April 2021. We used regression models to analyze the correlation among intravenous fluid (IVF) intake per kilogram, gestational age, fluid balance (FB), weight change, and sodium status, adjusting for clinical factors.</p><p><strong>Results: </strong>At 24 hours, the average IVF intake was 57.2 mL/kg/d (SD 14.9). Of the infants, 130 (75%) had positive FB, 128 (74%) maintained or gained weight, 41 (24%) had sodium levels 132 mEq/L or less, and 68 (39%) had sodium 134 mEq/L or less. Positive FB was associated with weight gain and an increased likelihood of hyponatremia. Regression analysis showed a 0.07-mEq/L decrease in serum sodium (95% CI, -0.09 to -0.05; <i>P</i> < .001) for every milliliter per kilogram of positive FB and a 6% increase in the odds of sodium 132 mEq/L or less (95% CI, 1.03-1.08; <i>P</i> < .001). Term infants exhibited greater decreases in sodium levels than preterm infants. Infants who did not receive enteral feeds had more pronounced sodium decreases compared with those who were fed.</p><p><strong>Conclusion: </strong>Positive FB was common and strongly associated with hyponatremia in infants receiving standard IVF rates. These effects were most significant in term and unfed infants. Current fluid strategies may overestimate needs, particularly for term infants not receiving enteral feeds.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening and Monitoring for Eating Disorders in Youth Presenting for Obesity Treatment.","authors":"Anna B Tanner, Lesley Williams, Andrea B Goldschmidt","doi":"10.1542/pedsos.2024-000333","DOIUrl":"10.1542/pedsos.2024-000333","url":null,"abstract":"","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occult Abdominal Trauma Screening in the Evaluation of Suspected Child Physical Abuse.","authors":"Tagrid M Ruiz-Maldonado, Joanne N Wood, Antoinette L Laskey, Christopher S Greeley, Angela Bachim, Daniel M Lindberg, James Anderst, John Melville, Carmen Coombs, Nancy S Harper, Lori Frasier, Farah W Brink, Caitlin E Crumm, Kristine A Campbell","doi":"10.1542/pedsos.2024-000274","DOIUrl":"10.1542/pedsos.2024-000274","url":null,"abstract":"<p><strong>Background and objectives: </strong>Occult abdominal trauma (OAT) screening with transaminases, followed by abdominal computed tomography (CT) for transaminase values greater than 80 IU/L, has been recommended in cases of suspected physical abuse. This study aimed to evaluate case characteristics associated with OAT evaluation and determine OAT prevalence in these children.</p><p><strong>Methods: </strong>Injured children aged younger than 60 months undergoing Child Abuse Pediatrics (CAP) consultation for suspected physical abuse from February 2021 to May 2023 were identified in CAPNET, a multicenter research network. Children with symptoms or signs of intra-abdominal injury were excluded. We identified case characteristics associated with transaminase screening and abdominal CT imaging using logistic regression and determined OAT prevalence.</p><p><strong>Results: </strong>Of 6161 eligible children, 3982 (64.6%) underwent transaminase screening; 687/3982 (17.3%) had transaminases greater than 80 IU/L with 298/687 (43.4%) undergoing abdominal CT imaging. Variability in screening and imaging practices was identified between CAPNET sites. In a fully adjusted model, transaminase screening was associated with ages younger than 6 months, greater clinical severity, and site. CT imaging was associated with site, inpatient status, and higher transaminase range. We identified 16 OAT cases in children with transaminases greater than 80 IU/L, representing 2.3% of CAP-evaluated children with positive transaminase screening and 0.3% of all eligible children.</p><p><strong>Conclusions: </strong>Providers often perform transaminase screening but not abdominal CT imaging despite transaminases greater than 80 IU/L. The low prevalence of OAT suggests that routine transaminase screening in suspected child physical abuse evaluations may not be necessary when all signs and symptoms of abdominal injury are absent.</p>","PeriodicalId":520527,"journal":{"name":"Pediatrics open science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}