Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2004
Randomized Controlled Trial Clinical TrialNoninvasive positive-pressure ventilation in children with lower airway obstruction.
Mechanical ventilation of patients with severe lower airway obstruction presents significant risks; therefore, avoiding the intubation in these patients has been a principal goal of clinical management. Noninvasive positive-pressure ventilation has been shown to be effective in treating adults with chronic obstructive pulmonary disease, but its use has not been studied prospectively in children with acute obstructive lower airways disease. The objective of this study was to determine whether noninvasive mask ventilation improved respiratory function in children with asthma and other obstructive lower airways diseases. ⋯ We conclude that noninvasive ventilation can be an effective treatment for children with acute lower airway obstruction.
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Pediatr Crit Care Me · Jul 2004
Randomized Controlled Trial Clinical TrialInspiratory work of breathing is not decreased by flow-triggered sensing during spontaneous breathing in children receiving mechanical ventilation: a preliminary report.
To determine the effect of pressure-trigger (PT) and flow-trigger (FT) sensing on the work of breathing (WOB) during spontaneous, unsupported breathing in children receiving mechanical ventilation. ⋯ FT may not decrease WOB compared with PT for unsupported spontaneous breathing in children receiving mechanical ventilation. However, when lung compliance is decreased, FT sensing may be advantageous in decreasing the WOB.
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Pediatr Crit Care Me · Jul 2004
Association of timing, duration, and intensity of hyperglycemia with intensive care unit mortality in critically ill children.
To study the association of timing, duration, and intensity of hyperglycemia with pediatric intensive care unit (PICU) mortality in critically ill children. ⋯ Hyperglycemia is common in critically ill children. Peak BG and duration of hyperglycemia are independently associated with mortality in our PICU. A prospective, randomized trial of strict glycemic control in this subset of critically ill children who are at high risk of mortality is both warranted and feasible.
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Pediatr Crit Care Me · Jul 2004
The use of a hemoglobin-based oxygen-carrying solution (HBOC-201) for extracorporeal membrane oxygenation in a porcine model with acute respiratory distress syndrome.
To evaluate whether hemoglobin-based oxygen-carrying solution (HBOC)-201 (Biopure) is an effective alternative to donor blood for extracorporeal membrane oxygenation support in a porcine model of acute respiratory distress syndrome (ARDS). ⋯ HBOC-201 appears to be an effective alternative circuit-priming agent for use during extracorporeal membrane oxygenation. HBOC offers the advantages of rapid availability and diminished donor blood cell exposure. The efficacy of HBOC in longer duration bypass, and its associated methemoglobinemia, need to be further investigated.
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Pediatr Crit Care Me · Jul 2004
Identifying children at high risk for psychological sequelae after pediatric intensive care unit hospitalization.
To identify those patients in a pediatric intensive care unit who may be at highest risk for developing persistent psychological sequelae after hospital discharge. ⋯ Findings suggest there is a group of children in the pediatric intensive care unit who are at higher risk for developing persistent psychological sequelae postdischarge. Exposure to high numbers of invasive procedures may be the driving force behind group differences, particularly at 6 wks postdischarge. These children warrant closer observation and follow-up.