Mechanism of @entity8193 in @entity1 with acute severe XXXX .

@entity1 @entity8770 @entity565 @entity26 @entity8193 @entity4456 @entity880 @entity2388
OBJECTIVE: @entity8770 and @entity8193 are common in adults with acute severe @entity565 however only a few cases have been reported in @entity1 . Type A @entity8193 is associated with impaired @entity26 delivery; type B occurs in the presence of normal @entity26 delivery and has been described to occur with excessive adrenergic stimulation. Type A and B @entity8193 can be distinguished by the blood @entity880 / @entity2388 ratio. Our objectives are to 1) investigate the incidence of @entity8770 and @entity8193 in @entity1 with acute severe @entity565 , and 2) determine whether @entity880 elevation is type A or B. DESIGN: Prospective observational study. SETTING: University-affiliated tertiary care @entity1 's hospital. @entity1 : All @entity1 (n = 105) with acute severe @entity565 admitted to the pediatric intensive care unit between @entity4456 , 2008 and November 30, 2009 were included. INTERVENTIONS: Blood @entity880 concentration was measured on a blood gas analyzer for all blood gas assessments obtained for clinical care. @entity8770 was defined as @entity880 >2.2 mmol/L and @entity8193 as @entity880 >5 mmol/L and pH <7.35. If @entity880 concentration was >5 mmol/L, consent was requested for measuring blood @entity880 and @entity2388 using enzymatic laboratory methods. @entity880 / @entity2388 ratio >25:1 indicated type A @entity8193 . MEASUREMENTS AND MAIN RESULTS: Eighty-seven (83%) @entity1 had @entity880 >2.2 mmol/L and 47 (45%) had @entity880 >5 mmol/L. Of those with @entity880 >5 mmol/L, 33 (70%) had corresponding blood pH <7.35. @entity880 / @entity2388 ratios were obtained for 16 @entity1 . Of these, @entity880 / @entity2388 ratio was <10 in three @entity1 ; 10-25 in 11; >25 in one; and indeterminate in one. CONCLUSIONS: @entity8193 is common in @entity1 with acute severe @entity565 and is primarily type B occurring in the presence of normal @entity26 delivery.
