Archives De Pediatrie最新文献

{"title":"Physiological and cerebral hemodynamic changes during routine nursing procedures for very preterm infants","authors":"Claire Koenig Zores ,&nbsp;Nicolas Mura ,&nbsp;Elodie Rabatel ,&nbsp;Meggane Melchior ,&nbsp;André Dufour ,&nbsp;Pierre Kuhn","doi":"10.1016/j.arcped.2024.08.009","DOIUrl":"10.1016/j.arcped.2024.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Care procedures for preterm infants can induce stress that may disrupt homeostasis, possibly altering cerebral perfusion or oxygenation. We evaluated the physiological and cerebral oxygenation changes during the routine care of very preterm infants.</div></div><div><h3>Methods</h3><div>We analyzed the changes in heart and respiratory rates and in systemic and regional cerebral oxygen saturation of 27 very preterm infants, defining three care periods of 5 min each: 30 min before care, 30 min during care, and 30 min after care. Mean maximum and minimum values for each parameter during the defined care periods were compared by analysis of variance (ANOVA) for repeated measures.</div></div><div><h3>Results</h3><div>The mean heart rate was significantly higher during (160 ± 8 bpm) than before and after care (151 ± 21 and 151 ± 6 bpm, respectively). The mean respiratory rate decreased during care and increased afterward: 44 ± 2.2, 40.6 ± 3.2, and 46.7 ± 3.4 cycles/min, respectively (<em>p</em> &lt; 0.05). The mean regional cerebral oxygen and systemic saturation did not vary significantly. Mean minimum and maximum values for each parameter varied during and after care as compared with before care (all <em>p</em> &lt; 0.01). The mean minimum cerebral and systemic saturation was lower after care than before care: 59 ± 8 % versus 63 ± 8 % and 83 ± 3 % versus 90 ± 7 %, respectively (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>During routine care procedures for very preterm infants, the change in physiological parameters suggested an autonomic stress reaction. Cerebral desaturation may occur during and after the care of such infants and call for specific attention to better support the physiological and cerebral well-being of these infants during standard care procedures.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 120-125"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From pediatric emergency department to pediatric intensive care unit: a retrospective study in a French Tertiary University hospital","authors":"Elsa Riche ,&nbsp;Aurelie Morand ,&nbsp;Sophie Fruscione ,&nbsp;Fabrice Michel ,&nbsp;Aurelie Boutin ,&nbsp;Valerie Bremond ,&nbsp;Valerie Arnoux ,&nbsp;Philippe Minodier","doi":"10.1016/j.arcped.2024.12.005","DOIUrl":"10.1016/j.arcped.2024.12.005","url":null,"abstract":"<div><h3>Objective</h3><div>The management of a child presenting with a critical medical or surgical condition is a scarce event in the pediatric emergency department (PED). In this one year retrospective study, we have tried to better characterize the profile and care pathway of children who had been transferred to the neonatal or pediatric intensive care or critical care units (PICCU) after a visit to the PED, or died in PED.</div></div><div><h3>Methods</h3><div>Retrospective study of children who has been transferred to PICCU from the two PED of Marseille's University Hospital from the 1^st of January 2022 until the 31^st of December 2022.</div></div><div><h3>Results</h3><div>Among the 82,962 children who consulted the two PED of Marseille's University Hospital in 2022, 260 (0.3 %) were transferred to PICCU or died in PED. The mean age was 42 months. There were 17 % newborns and 12 % infants aged 1 to 3 months old. The main reasons for referral was respiratory troubles (bronchiolitis 27.3 %, asthma 21.9 %), and neurological impairment (14.6 %). Thirty percent of children were previously followed for a chronic illness. In 45 %, a critical intervention was required: non-invasive or controlled ventilation, extracorporeal membrane oxygenation, use of amines and/or blood transfusion, surgery, and/or external cardiac massage. Two children died in the PED and six during the hospitalization. The mean duration of hospitalization in PICCU was 4.2 days.</div></div><div><h3>Conclusion</h3><div>In Marseille, during 2022, the occurrence of a critical child in PED was estimated at one every 300 children. These children were generally young and presented with respiratory or neurological pathologies. Care might require extensive resources or simple surveillance. Mortality was low (2.3 %).</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 126-131"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pseudotumoural optic neuritis in myelin oligodendrocyte glycoprotein antibody-associated disease in children","authors":"Julia Roux ,&nbsp;Domitille Bommier-Laur ,&nbsp;Mariana Calota ,&nbsp;Stéphane Auvin ,&nbsp;Kumaran Deiva","doi":"10.1016/j.arcped.2024.11.005","DOIUrl":"10.1016/j.arcped.2024.11.005","url":null,"abstract":"<div><div>Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a neuro-inflammatory condition affecting adults and children. The presentations vary and include acute disseminated encephalomyelitis, optic neuritis or transverse myelitis. Optic neuritis associated with anti-MOG antibodies is typically bilateral, anterior and initially severe but usually resolves quickly and completely. Here, we describe 3 children with pseudotumoural optic neuritis associated with anti-MOG antibodies and their outcome. Recognizing these unusual presentations may reduce unnecessary work-ups and improve functional prognosis by implementing rapid and adequate treatment.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 143-146"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food protein induced enterocolitis syndrome: French practices assessment in children","authors":"Amélie Perriere ,&nbsp;Karine Garcette ,&nbsp;Nicolas Kalach ,&nbsp;Patrick Tounian ,&nbsp;Anaïs Lemoine","doi":"10.1016/j.arcped.2024.12.003","DOIUrl":"10.1016/j.arcped.2024.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Food protein-induced enterocolitis syndrome (FPIES) is a specific non IgE-mediated food allergy. The international consensus guidelines defined diagnosis criteria and management plan in 2017.</div></div><div><h3>Objectives</h3><div>To assess practices regarding FPIES in France and in French-speaking countries, according to those guidelines.</div></div><div><h3>Methods and Setting</h3><div>We carried out a 22-question online survey to assess practices of specialised physicians (paediatricians, allergists, gastroenterologists, members of 2 French-speaking learning societies and/or working at hospitals in paediatric allergy units) following patients with FPIES between August 2019 and February 2022.</div></div><div><h3>Results</h3><div>We received 92 replies to our survey, mostly from hospital practitioners following less than 10 patients with FPIES. Oral rehydration solution and/or Ondansetron were largely prescribed in the emergency kit (61/72, 84.7 % and 47/72, 65.3 % respectively). 20 practitioners declared never prescribing an emergency kit. There was some confusion when distinguishing between FPIES and an IgE-mediated food allergy, as suggested by the unnecessary prescription of an antihistamine (18/72, 25.0 %) and/or epinephrine (11/72, 15.3 %) in the emergency kit. An explanatory FPIES emergency management letter to physicians in case of allergic reactions was provided in 83.7 % (77/92) of patients. Oral food challenge (OFC) practices varied greatly concerning doses: most respondents used several doses (52/92, 56.5 %) during the same day (33/52, 63.4 %). Eleven responders (12.0 %) used the same protocol as for an IgE-mediated food allergy.</div></div><div><h3>Conclusion</h3><div>Our survey showed that practices of FPIES management in France are generally aligned with the international consensus guidelines. There are still pending issues to be standardised, such as the emergency kit prescription and its contents, as well as OFC management strategies. This work confirms the need for continuous training of physicians regarding FPIES management. Further guidelines are needed to improve standardisation of FPIES management.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 114-119"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of physical activity in obese adolescents in Algeria","authors":"Fouzia Yous ,&nbsp;Salim Zaabar ,&nbsp;Omar Aoun ,&nbsp;Nawel Adjeroud-Abdellatif ,&nbsp;Radia Arab ,&nbsp;Khodir Madani","doi":"10.1016/j.arcped.2024.09.009","DOIUrl":"10.1016/j.arcped.2024.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>Adolescents are meant to spend a large part of their time practicing a hobby or sport, but currently there is a decline in their level of physical activity and sport both inside and outside schools, which can lead to a risk of obesity. The objective of the present study was to examine physical activity in obese adolescents within the school establishments of the province of Bejaia (northeastern Algeria).</div></div><div><h3>Method</h3><div>To determine the physical activity level (PAL) in the school population, a sample of 3,038 students with obesity comprising 1,635 girls and 1,403 boys was selected. The study focused on (a) the comparison of the intensity of physical activities practiced by girls and boys, (ii) the determination of the duration, intensity, and level of physical activity.</div></div><div><h3>Results</h3><div>The results show that obese girls are less active than obese boys at all ages (from 11 to 23 years) and in all locations; PALs was steady with increasing age for girls, while PALs increase with age in boys from 17 to 21. We found that some factors are associated with a decrease in PAL, such as the time spent watching television. Doing only 30 min of physical activity once a week is associated with an increase in sedentary behavior. The mean PALs of middle school (1.54) and high school (1.50) girls were lower than those observed for middle school (1.75) and high school (1.65) boys.</div></div><div><h3>Conclusions</h3><div>Our results show that obese girls are less active than obese boys and spend time watching television and practicing sports only at school.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 87-92"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of professional practices in the use of mexiletine for the management of childhood myotonia in French pediatric neuromuscular centers (MEXI-PEDI survey)","authors":"Sarah Barrière ,&nbsp;Véronique Manel ,&nbsp;Christine Barnerias ,&nbsp;Karim Wahbi ,&nbsp;Frédérique Audic ,&nbsp;Claude Cances ,&nbsp;Mondher Chouchane ,&nbsp;Ivana Dabaj ,&nbsp;Jean-Baptiste Davion ,&nbsp;Isabelle Desguerre ,&nbsp;Julien Durigneux ,&nbsp;Caroline Espil-Taris ,&nbsp;Gaelle Gousse ,&nbsp;Cyril Gitiaux ,&nbsp;Clémentine Lambert ,&nbsp;Cécile Laroche ,&nbsp;Vincent Laugel ,&nbsp;Anne-Gaelle Le Moing ,&nbsp;Yann Pereon ,&nbsp;Susana Quijano-Roy ,&nbsp;Catherine Sarret","doi":"10.1016/j.arcped.2024.10.009","DOIUrl":"10.1016/j.arcped.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Myotonia is the main feature of both myotonic dystrophy (DM) and non-dystrophic myotonia (NDM). It is felt as stiffness, pain, fatigue, and weakness. In France, mexiletine, a non-selective voltage-gated sodium channel blocker, is approved for the treatment of myotonia in adults with NDM, and it has a temporary recommendation for use in the symptomatic treatment of DM in adults. However, it is not currently licensed for treating myotonia in children due to the lack of studies on its use in pediatrics. This has meant heterogeneous practices in its utilization and has led to prescriber reluctance, which has jeopardized accessibility. We undertook a professional practice survey of French pediatric neuromuscular centers to determine their prescribing habits for mexiletine, assessing indications, doses, efficacy, and tolerance.</div></div><div><h3>Methods</h3><div>One medical pediatric professional from each French pediatric neuromuscular center belonging to the national neuromuscular network (FILNEMUS) was invited to complete an anonymous questionnaire.</div></div><div><h3>Results</h3><div>In total, 34 healthcare professionals responded. Of these, 16 had already treated a child for myotonia with mexiletine. Mexiletine was prescribed in one third of pediatric patients with NDM, but it was used in only 3% of DM type 1 patients and in no DM type 2 patients. Pre-treatment assessment always included a cardiac evaluation; however, the method of introduction (inpatient vs. outpatient basis), dosage adjustment, and efficacy evaluation ranged widely. More than half of the respondents reported a high efficacy of mexiletine in their patients; only three reported moderate adverse events (dyspepsia, loss of appetite, and asthenia).</div></div><div><h3>Conclusion</h3><div>The findings of this first survey on mexiletine for pediatric myotonia in France lend support for the creation of future national guidelines.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 107-113"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersectoral professionals’ understanding of the prevention of sexual violence against children, their role and that of the GP: A study using semi-structured interviews","authors":"Marie-Lou Avouac ,&nbsp;Rebecca Bonnetain ,&nbsp;Sylvie Morel ,&nbsp;Delphine Teigné ,&nbsp;Nicolas Hommey ,&nbsp;Rosalie Rousseau","doi":"10.1016/j.arcped.2024.11.004","DOIUrl":"10.1016/j.arcped.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>In 2020, the WHO reported a European prevalence of 9.6 % of sexual abuse among children, and called on every country to improve prevention of such violence.</div></div><div><h3>Objective</h3><div>To explore the understanding of an intersectional sample of professionals of their role and that of the general practitioner (GP) in the primary and secondary prevention of sexual violence against children (SVAC).</div></div><div><h3>Methods and Settings</h3><div>This qualitative, exploratory study was conducted in France. It followed COREQ criteria and ethical approval was obtained. Semi-structured interviews were conducted between February and October 2022 with intersectoral professionals involved in the identification and management of SVAC. The analysis was inspired by grounded theory.</div></div><div><h3>Results</h3><div>Thirteen professionals (from the media, healthcare, justice, police, education and social welfare sectors) shared their views regarding SVAC prevention. The notion that SVAC is a societal taboo recurred throughout the study. The content of participants’ discussions about prevention could be divided into four categories: (1) Intersectoral professionals’ understanding of prevention, prevention means talking about it; (2) Two, contrasting understandings of prevention and roles; (3) Putting primary and secondary SVAC prevention into practice; (4) The GP's role in SVAC prevention. The GP's role in SVAC prevention was perceived to, above all, involve screening and reporting. Primary prevention measures by GPs appeared to be less obvious.</div></div><div><h3>Discussion</h3><div>Our study reinforces the need and usefulness of intersectoral collaboration to improve SVAC prevention. It is in the interests of every professional to be appropriately trained, and to understand the roles of the various stakeholders, in order to work together.</div></div><div><h3>Conclusion</h3><div>While the WHO has called upon the healthcare sector to coordinate intersectoral collaboration for the prevention of SVAC, professionals, (including GPs) must be supported in order to systematically integrate prevention into the monitoring of children.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 132-137"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, etiological, radiological characteristics and outcomes of a cohort of 23 children with cerebral venous thrombosis in western Algeria","authors":"Zakaria Zoheir Addou ,&nbsp;Soumia Benilha ,&nbsp;Dalila Boumendil ,&nbsp;Kamel El Halimi","doi":"10.1016/j.arcped.2024.08.010","DOIUrl":"10.1016/j.arcped.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral venous thrombosis (CVT) is a rare condition in children, and its description remains limited in North Africa. The objective of our study was to describe the clinical, etiological, radiological, therapeutic, and evolutionary characteristics of children with CVT in western Algeria.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study involving children with CVT. The study was conducted at the unit of intensive care of Canastel Children's Hospital and the pediatric intensive care unit (PICU) of Oran Hospital Center (Algeria) from January 2012 to December 2022.</div></div><div><h3>Results</h3><div>A total of 23 children were included in the study, with an average age of 48±57 months. The most frequent clinical signs were fever (61 %), altered consciousness (61 %), seizures (56.6 %), and headaches (36.8 %). The primary risk factors were head and neck infections (36.8 %). Thrombosis mainly affected the transverse sinus (65.2 %), followed by the superior sagittal sinus (39 %). Associated cerebral complications primarily included hemorrhagic lesions (52 %), hydrocephalus (26 %), and venous ischemic infarction (13 %). Overall, 21 % of children with CVT died while 34 % of our cohort had unfavorable outcomes. Predictors of an unfavorable outcome in multivariate analysis were , parenchymal hemorrhage (aOR: 16.04; 95 % CI: 1.28–201.5), and mechanical ventilation (aOR: 10.50; 95 % CI: 1.02–108.6).</div></div><div><h3>Conclusion</h3><div>Due to the nonspecific nature of CVT clinical signs and considering the risk factors, it is essential to perform cerebral imaging to confirm the diagnosis and initiate early and effective treatment aimed at reducing potential neurological sequelae and the risk of death.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 100-106"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncorrected ametropia in children with limited access to ocular health care","authors":"Omri Clair ,&nbsp;Christine Morisset ,&nbsp;Rayan Mekoui ,&nbsp;Solène De Hedouville ,&nbsp;Flavien Lefebvre ,&nbsp;Emmanuel Marciano ,&nbsp;Emmanuel Bui Quoc","doi":"10.1016/j.arcped.2024.10.008","DOIUrl":"10.1016/j.arcped.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The primary objective of this study is to describe the refractive needs of vulnerable children according to their social security status. The secondary objective of this study is to describe the types of ametropia in this population of children with limited access to ocular health care.</div></div><div><h3>Methods</h3><div>Children with limited access to ocular health care were recruited. Their social security status was assessed as well as their need for optical correction. Children received an orthoptic and ophthalmological examination. The ametropia thresholds requiring optical correction were defined as follows: hyperopia if spherical equivalent (SE) ≥ 3D before 6 years, ≥ 2.25 D between 6 and 12 years, ≥ 1.5 D from 12 years onwards; myopia if SE ≤ 0.5 D; astigmatism if cylinder C ≥ 1D; anisometropia if sphere difference between both eyes ≥ 1D.</div></div><div><h3>Results</h3><div>Out of 83 planned patients, 60 children turned up. 51 files for children aged 1 to 14 years old were analysed. 63.2 % of children without social security required an optical correction, compared with 65.6 % of children receiving State Medical Aid (SMA) and 66.7 % of children receiving Universal Health Protection (UHP). Out of 102 eyes, SE was hypermetropic in 56.9 % of cases, myopic in 21.6 % of cases; astigmatism was present in 60.8 % of cases. Anisometropia was assessed in 27.5 % of cases. 33 children out of 51 (64.7 %) required correction with glasses.</div></div><div><h3>Discussion and Conclusion</h3><div>Children benefiting from SMA or UHP have similar refractive needs than children without social security, and probably greater than those of the general population. In our population there is two-thirds of patients with ametropia requiring optical correction; most of these children did not initially wear glasses, which suggests that access to ophthalmic and optical care is more difficult for vulnerable children.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 93-99"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of sedation using pentobarbital or chlorpromazine in pediatric non-invasive imaging procedures: A before and after study.","authors":"Elodie Morin ,&nbsp;Eric Xu ,&nbsp;Elise Sacaze ,&nbsp;Olivier Legeas ,&nbsp;Juliette Ropars","doi":"10.1016/j.arcped.2024.11.001","DOIUrl":"10.1016/j.arcped.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Sedation is often required for pediatric medical imaging procedures to ensure compliance and image quality. Recommendations for pediatric sedation exist, but there are currently no guidelines for the choice of the sedative drug.</div></div><div><h3>Objective</h3><div>To compare the efficacy and adverse events of per os pentobarbital with intravenous chlorpromazine in children undergoing diagnostic imaging procedures. We hypothesized that the efficacy of per os pentobarbital would not be inferior to that of intravenous chlorpromazine, that safety would be similar, and that patient acceptance would be higher.</div></div><div><h3>Material and Methods</h3><div>A pilot study (before and after study methodology) was performed. The sedation of 247 children with intravenous chlorpromazine or oral pentobarbital was evaluated for 6 months successively (independently by two radiologists, both blinded to the sedation technique). The primary outcome was sedation success as defined by an acceptable image quality. Secondary outcomes were induction time, length of hospital stay, adverse events, parental satisfaction and potential factors associated with failure of pentobarbital sedation.</div></div><div><h3>Results</h3><div>The sedation success rate of per os pentobarbital was found to be not inferior to that of intravenous chlorpromazine (83 % vs 90 %, <em>p</em> &lt; 0.01). Mean length of hospital stay was shorter with per os pentobarbital. Despite the higher incidence of agitation during recovery with per os pentobarbital, parents expressed a preference for it. Per os pentobarbital failed more often in children older than 5 years.</div></div><div><h3>Conclusion</h3><div>Per os pentobarbital may be an effective alternative to intravenous chlorpromazine, especially in children under 5 years of age.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 2","pages":"Pages 81-86"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}