In this work we tried to analyse the different factors which cooperate to produce and maintain a shock condition; we considered in particular pathophysiology and haemodynamic features of the different types of shock and the pathophysiology of MOSF (multiple systems organ failure). Furthermore, we remembered peculiarities and effects of the "reperfusion syndrome" which can occur after cardiopulmonary resuscitation of the patient due to superoxides. Finally we outlined the substantial and significant differences between newborn and not newborn concerning the haemodynamic responses and the cardiocirculatory management in the newborn during shock treatment.

Hemodynamics↗

PubMedDate not supplied

[Role of extracorporeal circulation in reversible acute cardiorespiratory insufficiency in neonatal and pediatric intensive care].

In the present study we try to analyze indications, contra-indication, side effects and limits of the use of extracorporeal circulation in neonatal and pediatric patients affected by reversible acute cardiorespiratory failure. The greatest experience on this technique has been achieved in the neonatal age (about 6000 newborns have been treated until now), while the employment in the pediatric age appears more recent (about 500 patients). Moreover, we focused on the drop-in criteria for neonatal and pediatric patients and on the clinical aspects and laboratory findings which can anticipate the surviving rate; the latter appears in any case much greater in the neonatal patient compared to the other pediatric ages.

Acute Disease↗

PubMedDate not supplied

[The clinical assessment and intensive treatment of meningoencephalitis in newborns and children of subsequent ages].

We focused on the best timing and management when admitting into intensive care unit a pediatric patient with central nervous system infection. The modified scales for pediatric patients did not prove satisfactory and reliable for making such decision. In fact the final score is obtained by adding the partial scores regarding the different clinical aspects. That bears a loss of informations. For this reason we think that the cardiorespiratory and metabolic parameters, assessed in a period of time, may indicate the moment when it is necessary to start an intensive care in these patients, regardless of consciousness. We therefore discussed the monitoring precociously required in these patients after assessing the initial clinical status. We also discussed the intensive care procedure employed in severely ill patients with cardio-circulatory and metabolic problems due to septic shock caused by bacterial meningoencephalitis (infants) and meningitis (other pediatric ages). In patients affected by infectious or post-infective encephalitis with respiratory failure and/or brain edema, it is essential to apply the organ protection procedures and particularly neuroprotection.

Adolescent↗