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  1. Article ; Online: Pediatric acute respiratory distress syndrome: How to protect the lungs during mechanical ventilation?

    Coronado-Muñoz, Álvaro / Escalante-Kanashiro, Raffo

    Boletin medico del Hospital Infantil de Mexico

    2021  Volume 78, Issue 3, Page(s) 181–190

    Abstract: Pediatric acute respiratory distress syndrome (PARDS) is a frequent diagnosis in critical care. This inflammatory process has different stages characterized by mild-to-severe hypoxia, and the management will vary according to the severity. New ... ...

    Title translation Síndrome de dificultad respiratoria aguda pediátrica: ¿cómo proteger los pulmones durante la ventilación mecánica?
    Abstract Pediatric acute respiratory distress syndrome (PARDS) is a frequent diagnosis in critical care. This inflammatory process has different stages characterized by mild-to-severe hypoxia, and the management will vary according to the severity. New definitions for pediatric patients were published in 2015; new epidemiological evidence revising those definitions has helped understand the mortality associated with PARDS and the impact on ventilation. The strategies to protect the lungs during mechanical ventilation have been successful in reducing mortality and complications. In clinical situations where high levels of critical support are limited, other therapies with a lower level of evidence can be attempted to gain time without worsening the ongoing pulmonary injury. We offer a complete narrative revision of this syndrome, with the critical management of these patients as a priority.
    MeSH term(s) Child ; Humans ; Lung ; Respiration, Artificial/adverse effects ; Respiratory Distress Syndrome/prevention & control
    Language English
    Publishing date 2021-06-24
    Publishing country Mexico
    Document type Journal Article
    ZDB-ID 730519-9
    ISSN 1665-1146 ; 1665-1146 ; 0539-6115 ; 0539-6123
    ISSN (online) 1665-1146
    ISSN 1665-1146 ; 0539-6115 ; 0539-6123
    DOI 10.24875/BMHIM.20000148
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Multisystem Inflammatory Syndrome in Children in COVID-19 Pandemic.

    Shah, Satish K / Munoz, Alvaro Coronado

    Indian journal of pediatrics

    2020  Volume 87, Issue 9, Page(s) 671–673

    MeSH term(s) Betacoronavirus ; COVID-19 ; Child ; Coronavirus Infections ; Humans ; Mucocutaneous Lymph Node Syndrome ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-07-03
    Publishing country India
    Document type Editorial ; Comment
    ZDB-ID 218231-2
    ISSN 0973-7693 ; 0019-5456
    ISSN (online) 0973-7693
    ISSN 0019-5456
    DOI 10.1007/s12098-020-03440-7
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  3. Article ; Online: Timing of Kidney Replacement Therapy Initiation and Survival during Pediatric Extracorporeal Membrane Oxygenation: An Extracorporeal Life Support Organization Registry Study.

    Anton-Martin, Pilar / Modem, Vinai / Bridges, Brian / Coronado Munoz, Alvaro / Paden, Matthew / Ray, Meredith / Sandhu, Hitesh S

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2024  

    Abstract: To characterize kidney replacement therapy (KRT) and pediatric extracorporeal membrane oxygenation (ECMO) outcomes and to identify the optimal timing of KRT initiation during ECMO associated with increased survival. Observational retrospective cohort ... ...

    Abstract To characterize kidney replacement therapy (KRT) and pediatric extracorporeal membrane oxygenation (ECMO) outcomes and to identify the optimal timing of KRT initiation during ECMO associated with increased survival. Observational retrospective cohort study using the Extracorporeal Life Support Organization Registry database in children (0-18 yo) on ECMO from January 1, 2016, to December 31, 2020. Of the 14,318 ECMO runs analyzed, 26% of patients received KRT during ECMO. Patients requiring KRT before ECMO had increased mortality to ECMO decannulation (29% vs. 17%, OR 1.97, P < 0.001) and to hospital discharge (58% vs. 39%, OR 2.16, P < 0.001). Patients requiring KRT during ECMO had an increased mortality to ECMO decannulation (25% vs. 15%, OR 1.85, P < 0.001) and to hospital discharge (56% vs. 34%, OR 2.47, P < 0.001). Multivariable logistic regression demonstrated that the need for KRT during ECMO was an independent predictor for mortality to ECMO decannulation (OR 1.49, P < 0.001) and to hospital discharge (OR 2.02, P < 0.001). Patients initiated on KRT between 24 and 72 hours after cannulation were more likely to survive to ECMO decannulation and showed a trend towards survival to hospital discharge as compared to those initiated before 24 hours and after 72 hours.
    Language English
    Publishing date 2024-01-31
    Publishing country United States
    Document type Journal Article
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000002151
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  4. Article ; Online: Pediatric acute respiratory distress syndrome

    Álvaro Coronado-Muñoz / Raffo Escalante-Kanashiro

    Boletín Médico del Hospital Infantil de México, Vol 78, Iss

    How to protect the lungs during mechanical ventilation?

    2021  Volume 3

    Abstract: Pediatric acute respiratory distress syndrome (PARDS) is a frequent diagnosis in critical care. This inflammatory process has different stages characterized by mild-to-severe hypoxia, and the management will vary according to the severity. New ... ...

    Abstract Pediatric acute respiratory distress syndrome (PARDS) is a frequent diagnosis in critical care. This inflammatory process has different stages characterized by mild-to-severe hypoxia, and the management will vary according to the severity. New definitions for pediatric patients were published in 2015; new epidemiological evidence revising those definitions has helped understand the mortality associated with PARDS and the impact on ventilation. The strategies to protect the lungs during mechanical ventilation have been successful in reducing mortality and complications. In clinical situations where high levels of critical support are limited, other therapies with a lower level of evidence can be attempted to gain time without worsening the ongoing pulmonary injury. We offer a complete narrative revision of this syndrome, with the critical management of these patients as a priority.
    Keywords Artificial respiration/methods. Respiratory distress syndrome. Adult. Prone position. Acute lung injury. Pediatrics ; Pediatrics ; RJ1-570 ; Public aspects of medicine ; RA1-1270
    Subject code 610
    Language English
    Publishing date 2021-07-01T00:00:00Z
    Publisher Permanyer
    Document type Article ; Online
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  5. Article: Presurgical Use of Hypoxic Mixture for Systemic Perfusion Improvement in Neonates With Complex Congenital Heart Disease: A Systematic Review and Meta-Analysis.

    Theurel Martín, Delia E / Alvarado Socarras, Jorge L / Manrique Hernández, Edgar F / Sandoval, Mónica A / Coronado Munoz, Alvaro J

    Cureus

    2024  Volume 16, Issue 2, Page(s) e53409

    Abstract: Oxygen therapy is essential for the survival of preterm babies and critically ill newborns; however, it has the potential to cause harm through hypoxemia or hyperoxemia. Newborns with complex congenital heart diseases (CHD) suffer from oxygen ... ...

    Abstract Oxygen therapy is essential for the survival of preterm babies and critically ill newborns; however, it has the potential to cause harm through hypoxemia or hyperoxemia. Newborns with complex congenital heart diseases (CHD) suffer from oxygen fluctuations due to the disease and its treatments, altering pre and postnatal development. The objective of this study is to evaluate the evidence for using a hypoxic mixture to decrease pulmonary over-circulation and improve systemic perfusion before surgical interventions in newborns with complex CHD that course with pulmonary over-circulation and systemic hypoperfusion. A search was conducted in PubMed, EMBASE, LILACS, Scielo, Taylor and Francis, SAGE, and Science Direct databases from 2000 to 2022 by two independent authors, including articles with hypoxic mixture treatment in observational studies or trials, with pre-treatment and post-treatment measurements in the same patient, or two groups or more comparisons. Six articles were selected, with a total of 75 patients. The primary outcome was improved systemic circulation and decreased pulmonary over-circulation measured directly with Qp/Qs and indirectly with oxygen saturation and cerebral near-infrared spectroscopy (NIRS). In addition, we performed a meta-analysis for oxygen saturation and cerebral NIRS. Oxygen saturation was the value uniformly reported; three studies reported a significantly lower oxygen saturation after the hypoxic mixture. The cerebral NIRS was measured in 4 studies, with inconsistent results. After using the hypoxic mixture, the Qp/Qs calculation was lower in the two studies but was not statistically significant. The meta-analysis for oxygen saturation showed a fixed effect post-hypoxic therapy of -0.7 (-1.06; -0.35), p < 0.001. The meta-analysis of two studies that measured cerebral NIRS did not show a statistically significant difference at 12 and 24 hours. In conclusion, this is the first systematic review and meta-analysis regarding the pre-operative use of hypoxic gas mixtures for newborns with complex congenital heart disease. Treatment results in lower oxygen saturations, but there is a lack of evidence of improvement in systemic perfusion. The utilization of this therapy is controversial, and better evidence is necessary.
    Language English
    Publishing date 2024-02-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.53409
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Severe diabetic ketoacidosis precipitated by COVID-19 in pediatric patients: Two case reports.

    Domínguez Rojas, Jesús Ángel / Tello Pezo, Mariela Violeta / Tasayco Muñoz, Jaime / Coronado Muñoz, Álvaro

    Medwave

    2021  Volume 21, Issue 3, Page(s) e8176

    Abstract: Introduction: The association of COVID-19 with diabetes mellitus is bidirectional. In one direction, diabetes mellitus is associated with an increased risk of severe COVID-19. In the opposite direction, in patients with COVID-19 new-onset diabetes ... ...

    Title translation Cetoacidosis diabética severa precipitada por COVID-19 en pacientes pediátricos: reporte de dos casos.
    Abstract Introduction: The association of COVID-19 with diabetes mellitus is bidirectional. In one direction, diabetes mellitus is associated with an increased risk of severe COVID-19. In the opposite direction, in patients with COVID-19 new-onset diabetes mellitus, severe diabetic ketoacidosis and severe metabolic complications have been described.
    Clinical case: This report describes two patients with diabetes mellitus who came to our hospital with ketoacidosis resulting from new-onset diabetes mellitus. We describe the clinical course and the management approach during the COVID-19 pandemic.
    Conclusion: COVID-19 is associated with metabolic complications such as severe diabetic ketoacidosis.
    MeSH term(s) Brain Edema/etiology ; COVID-19/complications ; Child ; Diabetic Ketoacidosis/etiology ; Female ; Humans ; Hypoxia, Brain/etiology ; Male
    Language English
    Publishing date 2021-04-23
    Publishing country Chile
    Document type Case Reports ; Journal Article
    ZDB-ID 2818022-7
    ISSN 0717-6384 ; 0717-6384
    ISSN (online) 0717-6384
    ISSN 0717-6384
    DOI 10.5867/medwave.2021.03.8176
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  8. Article ; Online: Methylene blue for the treatment of refractory septic shock secondary to listeriosis in a paediatric patient.

    Domínguez-Rojas, Jesús Angel / Caqui, Patrick / Sanchez, Abel / Coronado Munoz, Alvaro J

    BMJ case reports

    2022  Volume 15, Issue 2

    Abstract: Current therapies frequently used for refractory septic shock include hydrocortisone, vasopressin, extracorporeal membrane oxygenation (ECMO) support, inodilators, levosimendan and methylene blue. The evidence for these treatments is very limited. We ... ...

    Abstract Current therapies frequently used for refractory septic shock include hydrocortisone, vasopressin, extracorporeal membrane oxygenation (ECMO) support, inodilators, levosimendan and methylene blue. The evidence for these treatments is very limited. We present a case of a 5-year-old patient with refractory septic shock, secondary to
    MeSH term(s) Child ; Child, Preschool ; Extracorporeal Membrane Oxygenation/methods ; Female ; Humans ; Listeriosis/complications ; Listeriosis/drug therapy ; Methylene Blue/therapeutic use ; Shock, Septic/complications ; Shock, Septic/drug therapy ; Vasoconstrictor Agents/therapeutic use
    Chemical Substances Vasoconstrictor Agents ; Methylene Blue (T42P99266K)
    Language English
    Publishing date 2022-02-28
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2021-243772
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Multisystem Inflammatory Syndrome in Children in COVID-19 Pandemic

    Shah, Satish K. / Munoz, Alvaro Coronado

    The Indian Journal of Pediatrics

    2020  Volume 87, Issue 9, Page(s) 671–673

    Keywords Pediatrics, Perinatology, and Child Health ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 218231-2
    ISSN 0973-7693 ; 0019-5456
    ISSN (online) 0973-7693
    ISSN 0019-5456
    DOI 10.1007/s12098-020-03440-7
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  10. Article ; Online: Difficult acute lymphoblastic leukaemia diagnosis in a paediatric patient with mixed presentation of COVID-19 acute respiratory failure and multisystemic inflammatory syndrome.

    Domínguez-Rojas, Jesús Angel / Rojas-Soto, Ninoska / Vásquez-Hoyos, Pablo / Coronado Munoz, Alvaro J

    BMJ case reports

    2022  Volume 15, Issue 5

    Abstract: New diagnoses of leukaemia and other malignancies are recently being made in paediatric patients with COVID-19. The rates of mortality and morbidity in some of these children are expected to be higher. In new cases, concurrent diagnosis can be difficult ... ...

    Abstract New diagnoses of leukaemia and other malignancies are recently being made in paediatric patients with COVID-19. The rates of mortality and morbidity in some of these children are expected to be higher. In new cases, concurrent diagnosis can be difficult because multisystemic inflammatory syndrome (MIS-C) and malignancies have similar clinical presentations. We present the case of a preteenage child where the diagnosis of leukaemia was complicated and delayed by a multisystem involvement and an inconclusive bone marrow study. Clinical teams managing children with COVID-19 and MIS-C should suspect leukaemia and other malignancies when the clinical course is complicated and bone marrow suppression is persistent. Prompt diagnosis will allow start of treatment on time, minimising complications.
    MeSH term(s) COVID-19/complications ; Child ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis ; Respiratory Distress Syndrome ; Respiratory Insufficiency ; Systemic Inflammatory Response Syndrome/diagnosis
    Language English
    Publishing date 2022-05-20
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2021-248478
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