Slobodan Galić

The life-threatening hemodialysis catheter heparin lock caused bleeding in a child after peritoneal catheter removal

Hemodialysis catheter patency is regularly maintained by high-concentration heparin filling, according to manufacturers recommendation. Surprisingly, there are only few reports on serious bleeding complications in children on dialysis. A case of serious, life-threatening hemorrhage in a child after tunneled peritoneal catheter removal because of hemodialysis catheter heparin lock flushing is described. Discussion of the literature data is presented. Further investigations are needed to develop the guidelines for pediatric dialysis catheter care, including the optimal concentration for heparin lock as the possible heparin alternatives, but until that moment, previously suggested guidelines to prevent hemorrhagic complications in dialyzed children should be emphasized.

Renal thromboembolism during treatment with recombinant activated factor VII (rFVIIa) in a child with hemophilia B with factor IX inhibitors.

BackgroundSerious thromboembolic events connected with rFVIIa therapy in hemophilia patients are rare. Only three cases are reported in children, all of them with hemophilia A.Case presentationWe present unique case of patient with hemophilia B and high titer inhibitors to coagulation FIX, who developed severe renal damage due to thromboembolic event during rFVIIa therapy, associated with unsuspected renovascular anomalies.ConclusionCaution is necessary if hematuria B requires administration of rFVIIa. US color doppler renal imaging before and after drug administration should be sufficient as an early warning.

Fatal infant nasal seawater spray instillation: Fatal infant nasal seawater spray instillation

The use of seawater nasal spray is considered safe and sold as a non‐prescription medicine. However, it is well known that nasal manipulations can provoke vagal reaction leading to acute life‐threatening events. A case of fatal seawater nasal spray application in an infant is presented.

Fatal infant nasal seawater spray instillation.

UNLABELLED The use of seawater nasal spray is considered safe and sold as a non-prescription medicine. However, it is well known that nasal manipulations can provoke vagal reaction leading to acute life-threatening events. A case of fatal seawater nasal spray application in an infant is presented. CONCLUSION We do not consider the use of seawater nasal spray to be absolutely safe, especially among infants with disordered autonomic function.