Weekly Updates in Pediatrics         October 24, 2012 

EDITOR:  Jack Wolfsdorf, MD, FAAP 


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Treatment of pediatric inguinal hernia-effects of open vs laparoscopic approaches on testicular blood flow


Pre and post-operative testicular blood flow measurements undertaken on children undergoing open vs two different laparoscopic techniques to repair unilateral inguinal hernia, indicates while transient decreases in testicular blow flow may occur with the open technique, no method impaired testicular blood flow significantly.


Source: Journal of Pediatric Surgery

Natural history of small bowel failure following resection


The intestine undergoes tremendous growth during fetal life, elongating 1,000-fold between 5 and 40 weeks of gestation, reaching a maximum length of 275 cms at birth.


To characterize the natural history of small infants (GA: 34 weeks, BW: 2.1 kg) (aged < 12 months) who had small bowel intestinal failure (from a variety of causes) associated with a residual small bowel length of 41 cms, 272 infants in 14 pediatric centers were followed for 25.7 months.


At approximately 2 years of age, 27% of premature infants with small bowel failure will have died, 26% will have undergone intestinal transplantation and 47% will have achieved enteral autonomy.


Source: The Journal of Pediatrics

Is capnography useful in predicting hospital admission in bronchiolitis?




Source: Pediatric Emergency Care

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Factors associated with mechanical ventilation in children with bronchiolitis


Mean age for children with bronchiolitis who require CPAP and/or intubation is < 2 years.  


Other potential deleterious factors include:  

  • Maternal smoking during pregnancy
  • Birth weight (<5 lbs)
  • Dyspnea beginning < 1 day before admission
  • Inadequate oral intake
  • Severe retractions and arterial oxygen saturations in room air <85%

Source: Pediatrics

Video Feature

I feel dizzy!
Waking up after anesthesia: 
I feel dizzy!

TheDizzays8 via YouTube 

Long term differences in language and cognitive function after childhood anesthesia

Child Thinking


Immature animals apparently develop apoptic neuro degeneration and long-term cognitive deficiencies when exposed early in life to anesthesia.


A study of 2,068 children, approximately 10% of whom were exposed to anesthesia prior to age 3 years, and assessed at 10 years of age indicates that early exposure deleteriously effects receptive and expressive language, after even a single exposure to anesthesia. (As compared to their unexposed peers).


Source:  Pediatrics 

 Umbilical cord milking stabilizes oxygenation and perfusion in VLBW infants


The benefits of "early" vs "late" umbilical cord clamping remains contested, primarily because definitions of each vary considerably making comparisons virtually impossible.


Two matched groups of single, stable VLBW infants (one with cord milking, the other without cord milking) had a variety of left ventricular function studies undertaken, with superior vena cava flow and adequacy of cerebral tissue oxygenation comparisons made, at 3-72 hours after birth.    


Umbilical cord milking in VLBW infants stabilizes cerebral oxygenation and perfusion and enhances left ventricular function.  


Source:  The Journal of Pediatrics   

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