Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2001
Parental coping and bereavement outcome after the death of a child in the pediatric intensive care unit.
Parental grief after the death of a child may be influenced by the chronicity of the child's illness, the quality of care provided, and the parents' ability to cope. Our objective is to identify aspects of pediatric intensive care and parental coping that have a favorable effect on parental bereavement outcome. ⋯ Parents' physical well-being enables more effective handling of early grief. Parents' understanding of their own self-worth and their child's illness determine long-term adaptation to loss. A caring emotional attitude displayed by pediatric intensive care unit staff has beneficial short-term and long-term effects on parental bereavement.
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Pediatr Crit Care Me · Oct 2001
Respiratory syncytial virus infections in the pediatric intensive care unit: clinical characteristics and risk factors for adverse outcomes.
To describe the clinical characteristics of infants admitted to a pediatric intensive care unit (PICU) with respiratory syncytial virus (RSV) infection, including the prevalence of indications for RSV passive antibody prophylaxis (as currently recommended by the American Academy of Pediatrics), and to identify risk factors that predict adverse outcomes among this population. ⋯ A minority of infants admitted to our PICU for severe RSV disease meet currently recommended indications for RSV passive antibody prophylaxis. Risk factors that predict prolonged durations of ventilation, PICU stay, or hospital stay among this population include congenital heart disease, chronic lung disease, upper airway abnormalities, and noncardiac congenital malformations.
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Pediatr Crit Care Me · Oct 2001
Efficacy of an enteral 10-day methadone wean to prevent opioid withdrawal in fentanyl-tolerant pediatric intensive care unit patients.
To demonstrate the efficacy of a 10-day, single daily dose, enteral methadone weaning protocol for the prevention of opioid withdrawal symptoms in pediatric patients after prolonged fentanyl exposure. ⋯ Opioid withdrawal symptoms in pediatric intensive care unit patients after prolonged fentanyl exposure can be avoided by using an enteral, 10-day, single daily dose methadone weaning protocol.
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Pediatr Crit Care Me · Oct 2001
The impact of molecular biology on the practice of pediatric critical care medicine.
Molecular biology is increasingly affecting all areas of clinical medicine, including pediatric critical care medicine. Recent advances in genomics will allow for a more in-depth understanding of disease processes that are relevant to the pediatric intensivist, such as sepsis, the acute respiratory distress syndrome, and multiple organ dysfunction syndrome. In turn, understanding critical illness at the genomic level may allow for more effective stratification of patient subclasses and targeted, patient-specific therapy. ⋯ Finally, prospects for gene therapy, although quite challenging at present, may be applicable to the intensive care unit in the near future. With these rapid advancements in molecular biology, it is imperative that all pediatric critical care practitioners become, at least, familiar with the field and its related technology. Hopefully, clinician-scientists involved in pediatric critical care will also shape the direction of these future prospects.