Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2004
Current limitations of volumetric capnography in surfactant-depleted small lungs.
To investigate the suitability of volumetric capnography for assessing alveolar gas exchange in very small, surfactant-depleted lungs. ⋯ Volumetric capnography is a useful tool to detect impaired alveolar gas exchange in surfactant-depleted small lungs. However, the method failed if there was no alveolar plateau in the volumetric capnogram especially in stiff lungs with short exhalation times.
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Pediatr Crit Care Me · Jan 2004
Multicenter Study Comparative StudySeverity of injury and mortality associated with pediatric blunt injuries: hospitals with pediatric intensive care units versus other hospitals.
To a) compare in-hospital mortality rates for pediatric (age <13 yrs) patients with blunt injuries in the New York State Trauma Registry based on hospital type (dedicated pediatric intensive care unit [PICU] and designated trauma centers and noncenters that do not have a dedicated PICU) for the purpose of determining whether there is a reduction in mortality at a specialty hospital and b) determine the extent to which high-risk patients are admitted to specialty hospitals. ⋯ There is significant triaging of the most seriously injured pediatric trauma inpatients to PICUs, and there is evidence that this policy is effective.
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Pediatr Crit Care Me · Jan 2004
Review Case ReportsCavernous sinus thrombosis complicating sinusitis.
Septic cavernous sinus thrombosis is a rare complication of paranasal sinusitis. ⋯ The diagnosis of septic cavernous sinus thrombosis requires a high index of suspicion and confirmation by imaging; early diagnosis and surgical drainage of the underlying primary source of infection in conjunction with long-term intravenous antibiotic therapy are critical for an optimal clinical outcome.
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Acidosis is now recognized as an important component of the severe malaria syndrome and a predictor of fatal outcome. Alterations in plasma potassium concentrations are commonly associated with acidosis. To date, there is little information about the changes in potassium in severe malaria. ⋯ Hypokalemia is a common complication of severe malaria; however, it is often not apparent on admission. On correction of acidosis, plasma potassium decreases precipitously, and thus careful, serial monitoring of serum potassium is suggested in patients with severe malaria complicated by acidosis.
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Pediatr Crit Care Me · Jan 2004
Clinical Trial Controlled Clinical TrialDecreasing unplanned extubations: utilization of the Penn State Children's Hospital Sedation Algorithm.
To determine whether institution of a standardized algorithm of goal-directed sedation impacted the incidence of unplanned extubations in critically ill pediatric patients. ⋯ Utilization of the PSCHSA resulted in a decreased number of unplanned extubations without increasing the length of PICU stay. Implementation of the PSCHSA is needed in other PICUs to validate these findings.