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June 1974

Pediatric Multipurpose Intensive Care Unit

Author Affiliations

Children's Hospital Division of Cardiology Department of Pediatrics University of Cincinnati Cincinnati, OH 45229

Am J Dis Child. 1974;127(6):795-796. doi:10.1001/archpedi.1974.02110250021003

On page 862 of this issue of the Journal, Bhatt et al report the urgent and complex problems that arise in the management of a child critically ill with rabies. More than three weeks of intensive medical care was required for this patient. Initially, the child was unable to handle oral secretions. Subsequently, there was progressive neurologic impairment. The use of artificial ventilation was instituted because of hypoventilation and spells of apnea. Regulation of inspired oxygen concentration and tidal volume of the respirator was frequently necessary. Dislodgment of this patient's tracheostomy tube led to cardiac arrest. During resuscitation, ventricular fibrillation was treated with electrical countershock. A chronotropic and positive inotropic agent, isoproterenol, was infused under constant vigilance in order to restore blood pressure and heart rate. External cardiac massage was employed to treat a second cardiac arrest. An excessive intake of fluids resulted in congestive cardiac failure. Inappropriate secretion of

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