Epidural analgesia has widespread use in infants and children for postoperative pain management and for certain chronic pain conditions such as cancer pain and complex regional pain syndrome. While epidurals can provide excellent analgesia in pediatric patients, they do require specific expertise in both the techniques of placement and in the management. Pediatric-specific protocols and guideli...

We report a patient with profound hypovolemia who developed dynamic left ventricular outflow tract obstruction and severe mitral regurgitation. Both the outflow tract obstruction and mitral regurgitation resolved with volume replacement. Unlike previous reports of dynamic left ventricular outflow obstruction and mitral regurgitation, the degree of mitral regurgitation was severe. Possible mecha...

Hyperoncotic albumin proved ineffective as a plasma volume expander in the resuscitation of four acutely burned children. Hypovolemia and pulmonary edema were apparently intensified by an obligatory fluid shift following tissue extravasation of protein. We conclude that, when used, hyperoncotic albumin should be suspended in a sufficient volume of saline to produce a solution isotonic and iso-o...

The mechanisms involved in the maintenance of sodium homeostasis are reviewed. Emphasis is placed on localization of sodium reabsorption, effects of physical factors on glomerular ultrafiltration and tubular reabsorption, and action of certain hormones. Responses to arterial hypovolemia and hypervolemia are reviewed.

Placental invasion anomalies are rare obstetrical complications. They cause severe third trimester hemorrhage, severe postpartum bleeding, and maternal morbidity and mortality unless they are diagnosed antenatally. We present a rare case with placenta percreta leading to spontaneous uterine rupture during the second trimester with an acute abdomen and hypovolemia.