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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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A Mouse Fetal Skin Model of Scarless Wound Repair
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Pediatric Skin Failure.

Katie E Cohen1, Matthew C Scanlon1, Amin Bemanian1

  • 1Katie E. Cohen is a medical student, Matthew C. Scanlon is a professor of pediatrics, and Amin Bemanian is a medical student at the Medical College of Wisconsin, Milwaukee, Wisconsin. Christine A. Schindler is a clinical assistant professor, College of Nursing, Marquette University, Milwaukee, Wisconsin.

American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses
|July 3, 2017
PubMed
Summary
This summary is machine-generated.

Critically ill children with severe organ dysfunction may experience acute skin failure, not preventable pressure ulcers. This condition, linked to multiple organ dysfunction syndrome (MODS), has a high mortality rate in pediatric intensive care units.

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Area of Science:

  • Pediatric critical care medicine
  • Dermatology
  • Pathophysiology of critical illness

Background:

  • Skin failure is recognized in adults but often misclassified as pressure ulcers in children.
  • Current pediatric literature indiscriminately groups severe skin injuries as pressure ulcers.

Purpose of the Study:

  • To identify and characterize the phenomenon of acute skin failure in critically ill pediatric patients.
  • To differentiate acute skin failure from traditional pressure ulcers in this population.

Main Methods:

  • Retrospective chart review of 19 pediatric patients with serious skin injuries.
  • Analysis of organ dysfunction scores, medications, pressure ulcer prevention, and laboratory values preceding skin lesion development.

Main Results:

  • All patients had preventive measures in place; injuries were full-thickness upon identification.
  • 18/19 patients had multiple organ dysfunction syndrome (MODS) with at least 2 dysfunctional systems.
  • Mortality rate was 42% in this cohort, significantly higher than the general pediatric intensive care unit population (1.8%).

Conclusions:

  • A subset of severe skin injuries in critically ill children may represent acute skin failure secondary to MODS.
  • This challenges the traditional view of pressure ulcers as entirely preventable in this vulnerable group.