Journal of Pediatric Perspectives

Background: The present study was performed to investigate the level of knowledge, attitude, and performance of healthcare personnel working in COVID-19 hospitals in Mashhad regarding ... Read More

original article

Validity of Three Formulas for Measuring Endotracheal Tube Insertion Depth in Children under Mechanical Ventilation

Narges Keshvarparast; Nemat Bilan; Farinaz Amirikar

Volume 11, Issue 3 , March 2023, Pages 17463-17469

https://doi.org/10.22038/ijp.2023.66353.4989

Abstract

Background: In the process of intubation, inappropriate placement of the endotracheal tube can lead to hypoxemia, aspiration, insufficient ventilation, atelectasis, barotrauma and pneumothorax. ... Read More Background: In the process of intubation, inappropriate placement of the endotracheal tube can lead to hypoxemia, aspiration, insufficient ventilation, atelectasis, barotrauma and pneumothorax. The above complications may be difficult for a patient with severe disease to tolerate; especially when inappropriate placement is not detected by the specialist in the initial evaluation and the diagnosis lasts until the confirmatory chest x-ray is performed. This study evaluated the validity of three formulas in measuring the depth of endotracheal intubation in children under mechanical ventilation.Methods: 60 intubated children aged 2 months to 12 years were included in this study. The patients were randomly divided into three study groups. Endotracheal tube length for each patient was calculated on the basis of the endotracheal tube length formulas (12 + age (years) / 2; endotracheal tube diameter * 3; and 5 + height (cm) / 10). The ideal depth of the endotracheal tube based on chest x-ray was measured as the median distance between the first thoracic vertebra (T1) and the carina in cm. The distance between the ideal depth of the endotracheal tube and the end location of the endotracheal tube was also measured and recorded.Results: The mean age of the patients was 42.90 months and 58.3% of them were boys. The most common indication for intubation was pneumonia, along with respiratory distress (33.3%). Considering the difference in endotracheal tube depth between the two values calculated using the formula and chest X-ray equal to± 0.5 cm, formula 12 + (2 / age) in 55% of patients, formula 3 * endotracheal tube length in 70% patients and formula 5 + (10 / height) in 85% of patients, were correctly estimated endotracheal tube length. On the other hand, it was observed that in 15%, 45% and 40% of the patients, the formula predicted the correct length of the endotracheal tube for correct intubation without any difference while compared to the chest X-ray. In evaluating the results obtained from the formula and length of the endotracheal tube measured by chest X-ray, it was also observed that the formulas 12 + (2 / age), 3 * length of the endotracheal tube and 5 + (10 / height) were significantly correlated with CXR.Conclusion: According to the obtained results, it can be concluded that the formulas used to estimate the depth of endotracheal tube placement in children have low accuracies compared to the gold standard of measurement (chest X-ray). Of course, in comparison to the three formulas (height, weight and diameter of the ETT), the height formula was more accurate than others.

original article

The Effectiveness of Parenteral Hydroxylcobalamin on Urine Mma in Children with Methylmalonic Acidemia

Afsane Nazari; Sepideh Bagheri; Zahra Abbasi Shaye; sara shirdelzade; Nafiseh Pourbadakhshan; peyman eshraghi

Volume 11, Issue 3 , March 2023, Pages 17470-17476

https://doi.org/10.22038/ijp.2023.70401.5182

Abstract

Background: Methylmalonic acidemia is a rare autosomal recessive disease in which there is a deficiency of intracellular cobalamin. This study aimed to assess the effectiveness of parenteral ... Read More

original article

Regularity in Breakfast and Snacks Intake and Its Relationship with Weight Status in Elementary School Students: A Cross Sectional Study

Fariba Hosseinzadegan; Masoumeh Hemmati Maslak Pak; Farideh Namadi; Davoud Vahabzadeh

Volume 11, Issue 3 , March 2023, Pages 17477-17486

https://doi.org/10.22038/ijp.2023.69856.5152

Abstract

Background: Childhood weight status is one of the important predictors of health status later in life. Some previous studies have postulated a relationship between the pattern of breakfast ... Read More

original article

Oxygenation and Ventilation Indices in Relation to the Duration of Mechanical Ventilation in 2-Month to 14-Year-Old Children Admitted to PICU

Zahra Pourramazan; Nemat Bilan; Farinaz Amirikar

Volume 11, Issue 3 , March 2023, Pages 17487-17494

https://doi.org/10.22038/ijp.2023.66498.4991

Abstract

Background: Respiratory diseases are the most common cause of death in the pediatric population and acute or progressive respiratory failure, which requires mechanical ventilation, ... Read More Background: Respiratory diseases are the most common cause of death in the pediatric population and acute or progressive respiratory failure, which requires mechanical ventilation, is the most common cause of children’s hospitalization in the intensive care unit. Despite advances in recent decades regarding the treatment of acute respiratory diseases in children and innovative settings in mechanical ventilation, there are no clear and comprehensive guidelines for the use of mechanical ventilation in children.Objective: This research aimed to evaluate the correlation between oxygenation and ventilation indices in predicting the duration of mechanical ventilation in children aged two months to 14 years old admitted to PICU.Methods: In this cross-sectional study, 56 patients were included. The required information was extracted from the patients' clinical records and entered into the prepared questionnaires. They included age, sex, and diagnosis, duration of intubation, extubation time, mechanical ventilation parameters, and blood gas parameters. Patients' blood and ventilation data were collected and calculated from the first day of mechanical ventilation until 7 days later to calculate Oxygenation (OI) and Ventilation (VI) indices.Results: Pneumonia, the most common cause of hospitalization in the intensive care unit and the need for intubation, was present in our population (82%) due to aspiration and Covid-19 disease. There was a significant relationship between higher levels of FiO2 and longer duration of patients' intubation (P <0.001). The amount of PIP in each of the first days of intubation was significantly correlated with the duration of the study. A significant direct relationship was found between the ventilation index and oxygenation index. (P <0.05) Except for the sixth day, oxygenation index and duration of intubation were significantly correlated. (P <0.05) This means that along with the increase in oxygenation index, the duration of intubation was also increased. Ventilation index and duration of intubation were also significantly correlated, except on the fourth and fifth days (P <0.05). None of the extubated patients required re-intubation. Eventually, a very weak statistical correlation was found between the intubation period and the final result in the form of discharge and recovery of the patient or his death.Conclusion: Using variables such as gender, PIP and oxygenation, and ventilation indices, in the early days of mechanical ventilation, the prognosis of these patients and better management of their treatment can be judged. It is, finally, emphasized that further studies on larger populations, with more variables and long-term follow-ups are required.

review article

Radiology Approach of Precocious Puberty: A Review on Different Available Imaging Modalities

Soheil Arekhi; Alireza Omranzadeh; Masoud Mahdavi rashed

Volume 11, Issue 3 , March 2023, Pages 17495-17513

https://doi.org/10.22038/ijp.2023.69882.5155

Abstract

Diagnosis and management of precocious puberty are challenging. The two main classes of precocious puberty are Central Precocious Puberty (CPP) and Peripheral Precocious Puberty (PPP), ... Read More

review article

Ultrasonography in pediatric neck cystic lesions

Ahmad Hesari; Masoud Mahdavi Rashed

Volume 11, Issue 3 , March 2023, Pages 17514-17526

https://doi.org/10.22038/ijp.2023.70164.5167

Abstract

Diagnosis of the cystic lesion of the neck in pediatric cases is challenging for radiologists. There are different cystic lesions in the neck region that can present themselves in various ... Read More

case report

Pediatric Pancreatoblastoma: A Case Report

Amirreza Jahanshahi; Azim Rezamand; Amir Vahedi; Meisam Ganjei; Masih Falahatian; Reyhaneh Falaki; Faezeh Rahimi; Ghazaleh Bani; Yasin Sadeghi-Bazargani

Volume 11, Issue 3 , March 2023, Pages 17527-17536

https://doi.org/10.22038/ijp.2023.70357.5180

Abstract

Background: Pancreatoblastoma (PB) is an exceedingly uncommon pancreatic tumor arising from pancreatic exocrine cells. It is the most common malignant pancreatic tumor in childhood.Case ... Read More

case report

Hydatid Cyst Presented With Orbital Cellulitis Manifestation: A Case Report and Brief Literature Review

Mehrdad Motamed Shariati; Aliakbar Saber Moghaddam; Mohammad Yaser Kiarudi; Seyed Hossein Ghavami Shahri

Volume 11, Issue 3 , March 2023, Pages 17537-17543

https://doi.org/10.22038/ijp.2023.64212.4886

Abstract

Background: This study aimed to report on the case of a child with the manifestation of orbital cellulitis which was finally diagnosed as an orbital hydatid cyst.Case report: The case ... Read More

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Volume & Issue: Volume 11, Issue 3, March 2023, Pages 17453-17543

The Level of Knowledge, Attitude, and Performance of Healthcare Personnel in COVID-19 Hospitals Regarding the Use of Respiratory Protection Equipment

Abstract

Validity of Three Formulas for Measuring Endotracheal Tube Insertion Depth in Children under Mechanical Ventilation

Abstract

The Effectiveness of Parenteral Hydroxylcobalamin on Urine Mma in Children with Methylmalonic Acidemia

Abstract

Regularity in Breakfast and Snacks Intake and Its Relationship with Weight Status in Elementary School Students: A Cross Sectional Study

Abstract

Oxygenation and Ventilation Indices in Relation to the Duration of Mechanical Ventilation in 2-Month to 14-Year-Old Children Admitted to PICU

Abstract

Radiology Approach of Precocious Puberty: A Review on Different Available Imaging Modalities

Abstract

Ultrasonography in pediatric neck cystic lesions

Abstract

Pediatric Pancreatoblastoma: A Case Report

Abstract

Hydatid Cyst Presented With Orbital Cellulitis Manifestation: A Case Report and Brief Literature Review

Abstract