Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2003
Nosocomial urinary tract infections in children in a pediatric intensive care unit: a follow-up after 10 years.
To define nosocomial urinary tract infection (NUTI) rates in a pediatric intensive care unit, and determine whether practice recommendations have been sustained after 10 yrs. ⋯ NUTIs in children in our pediatric intensive care unit were associated with previous cardiovascular surgery and with urinary tract catheterization of at least 3 days. The need for careful fluid monitoring by catheterization must be balanced against the increased risk of catheter-related urinary tract infection. Removal of urinary catheters at the earliest opportunity will prevent many infections. Ongoing education or innovative strategies will be required to sustain optimal practice.
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Pediatr Crit Care Me · Jan 2003
ReviewInnovative practices of ventilatory support with pediatric patients.
The recognition that alveolar overdistension rather than peak inspiratory airway pressure is the primary determinant of lung injury has shifted our understanding of the pathogenesis of ventilator-induced side effects. In this review, contemporary ventilatory methods, supportive treatments, and future developments relevant to pediatric critical care are reviewed. ⋯ The methods proposed require confirmation through large controlled clinical trials that can assess the efficacy reported in pilot studies and case reports and define the optimal method(s) to treat individual pathologies in the various pediatric age groups.
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Pediatr Crit Care Me · Jan 2003
Prospective study of potassium-associated acute transfusion events in pediatric intensive care.
Transfusion of packed red blood cells containing high concentrations of potassium have been associated with fetal and neonatal arrhythmia and hyperkalemic cardiac arrest. This study sought to determine the biochemical and associated clinical effects of packed red blood cells transfusion in critically ill children. ⋯ This prospective study found no significant change in patient potassium concentration and no acute adverse events related to transfusion in critically ill children, including those receiving packed red blood cells by bolus. Larger prospective studies are required to evaluate the acute effects of rapid and central venous transfusion in critically ill children.
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Pediatr Crit Care Me · Jan 2003
Jugular venous oxygen saturation or arteriovenous difference of lactate content and outcome in children with severe traumatic brain injury.
To assess the association between neurologic out-come and the alterations of jugular venous oxygen saturation (SjvO2) or the increase in arteriovenous difference of lactate content (AVDL) in children with severe traumatic brain injury. ⋯ In children with severe traumatic brain injury, two or more measurements of SjvO2 of < or = 55% or two or more pathologic AVDL measurements were associated with a poor neurologic outcome. Further studies are needed to recommend the use of these variables as a guideline to optimize treatment.