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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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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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Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches01:23

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Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
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Quantifying the need for pediatric REBOA: A gap analysis.

Christina M Theodorou1, A Francois Trappey2, Carl A Beyer1

  • 1University of California Davis Medical Center, Department of Surgery, Sacramento, CA.

Journal of Pediatric Surgery
|October 13, 2020
PubMed
Summary
This summary is machine-generated.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) may benefit nearly 20% of severely injured pediatric trauma patients. This study identified REBOA-amenable injuries in children, suggesting its potential role in pediatric trauma care.

Keywords:
Gap analysisPediatric REBOAPediatric traumaREBOAResuscitative endovascular balloon occlusion of the aorta

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Area of Science:

  • Pediatric Trauma Surgery
  • Emergency Medicine
  • Vascular Surgery

Background:

  • Trauma is the leading cause of death in children.
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used for hemorrhage control but its pediatric application is unassessed.
  • This study investigates the potential benefit of REBOA in pediatric trauma patients.

Purpose of the Study:

  • To determine the proportion of severely injured pediatric trauma patients who have injuries amenable to REBOA.
  • To assess the potential utility of REBOA in managing pediatric trauma-related hemorrhage.

Main Methods:

  • Retrospective comparative study of pediatric trauma patients (<18 years) from 2009-2019 at a level 1 pediatric trauma center.
  • Identified severely injured patients based on mortality, pre-hospital cardiac arrest, massive transfusion, or hemorrhage control surgery.
  • Focused on patients with intra-abdominal injuries (solid organ, vascular, pelvic hemorrhage) potentially treatable with REBOA.

Main Results:

  • Out of 6538 pediatric traumas, 239 were severely injured, with 38 (15.9%) having REBOA-amenable injuries.
  • These 38 patients accounted for 10.2% of all pediatric trauma deaths at the center, with a 34.2% mortality rate.
  • REBOA-amenable injuries represented 0.6% of all pediatric traumas, with 11 patients (28.9%) also having traumatic brain injury (TBI).

Conclusions:

  • Approximately 20% of severely injured pediatric patients may be candidates for REBOA.
  • The prevalence of REBOA-amenable injuries in pediatric trauma is comparable to that observed in adult populations.
  • REBOA presents a potential therapeutic option for specific pediatric trauma cases involving severe hemorrhage.