The Journal of pediatrics
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The Journal of pediatrics · Aug 2015
Sedatives and Analgesics Given to Infants in Neonatal Intensive Care Units at the End of Life.
To describe the administration of sedatives and analgesics at the end of life in a large cohort of infants in North American neonatal intensive care units. ⋯ Administration of sedatives and analgesics increased over time. Infants of older gestational age and those more critically ill were more likely to receive these drugs on the day of death. These findings suggest that drug administration may be driven by severity of illness.
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The Journal of pediatrics · Aug 2015
Extracorporeal Membrane Oxygenation in Pediatric Trisomy 21: 30 Years of Experience from the Extracorporeal Life Support Organization Registry.
To describe the use of extracorporeal membrane oxygenation (ECMO) in patients with trisomy 21 (T21), to identify risk factors for hospital mortality, and to compare outcomes with those of patients without T21. ⋯ The use of ECMO in patients with T21 has increased over time. Patients with a cardiac indication for ECMO have higher mortality compared with those supported for respiratory indications. Despite differences in indications for ECMO, patients with T21 have similar hospital survival as those without T21; thus, by itself, a diagnosis of T21 should not be considered a risk factor for in-hospital mortality when contemplating ECMO cannulation.
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To synthesize the perspectives of a broad range of pediatric palliative care (PPC) clinicians and parents, to formulate a consensus on prioritization of the PPC research agenda. ⋯ This modified Delphi survey used professional and parental consensus to identify preeminent PPC research priorities. Attentiveness to these priorities may help direct resources and efforts toward building a formative evidence base. Investigating PPC implementation approaches and outcomes can help improve the quality of care services for children and families.
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The Journal of pediatrics · Jul 2015
Randomized Controlled Trial Multicenter StudyMask versus Nasal Tube for Stabilization of Preterm Infants at Birth: Respiratory Function Measurements.
To compare the nasal tube with face mask as interfaces for stabilization of very preterm infants at birth by using physiological measurements of leak, obstruction, and expired tidal volumes during positive pressure ventilation (PPV). ⋯ The use of a nasal tube led to large leak, more obstruction, and inadequate tidal volumes compared with face mask.
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The Journal of pediatrics · Jul 2015
Multicenter StudyUse of Cough and Cold Medications in Severe Bronchiolitis before and after a Health Advisory Warning against Their Use.
We compared the use of cough and cold medications in 2 multicenter studies of young children hospitalized with bronchiolitis before and after the 2008 Food and Drug Administration cough and cold medications advisory. Although cough and cold medication use decreased after the advisory, nearly 20% of children age 12-23.9 months with severe bronchiolitis received cough and cold medications.