Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2005
Comparative Study Clinical TrialPressure support ventilation combined with volume guarantee versus synchronized intermittent mandatory ventilation: a pilot crossover trial in premature infants in their weaning phase.
To compare pressure support ventilation combined with volume guarantee (PSV-VG) to synchronized intermittent mandatory ventilation (SIMV) regarding safety, course of blood gases, and infant-ventilator interaction in premature infants. ⋯ The potentials of PSV-VG to improve infant-ventilator synchrony and to decrease pressure needed to ventilate premature lungs are promising, even though the changes were small. However, its benefits during acute illness and on the final outcome remain to be proven.
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Pediatr Crit Care Me · May 2005
ReviewReducing the global burden of sepsis in infants and children: a clinical practice research agenda.
Sepsis remains a predominant cause of mortality and morbidity in children in the developing and industrialized world. This review discusses a clinical practice research agenda to reduce this global burden. ⋯ The global burden of sepsis can be reduced by 1) prevention with improved heterologous or specific vaccines and vitamin or mineral supplement programs; 2) early recognition and treatment with appropriate antibiotics, intravenous fluid resuscitation, and inotropic support in organized healthcare-delivery systems; and 3) development of new diagnostics and therapeutics that reduce systemic thrombosis, improve immune function, and kill resistant organisms.
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Pediatr Crit Care Me · May 2005
Comparative StudyExtracellular hsp70 levels in children with septic shock.
To determine whether hsp70 is elevated in the plasma of children with septic shock. ⋯ Extracellular hsp70 levels are significantly elevated in children with septic shock compared with controls. Given the newly described cell signaling properties of hsp70, these data suggest that extracellular hsp70 may play a role in the host response during septic shock.
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Pediatr Crit Care Me · May 2005
ReviewPhysicians' ability to diagnose sepsis in newborns and critically ill children.
To elucidate physicians' ability to correctly diagnose infection in critically ill children in three different situations: 1) post hoc adjudication (e.g., ward rounds, outcome determination in surveillance studies or controlled trials), 2) when decisions must be made (e.g., sepsis workup in suspected infection), c) and applying suggested adult consensus conference definitions in children. ⋯ Misclassification is a serious threat in post hoc adjudication of episodes or when consensus definitions rely on the application of criteria with imperfect sensitivity (e.g., the positivity of blood cultures in premature infants or children). This underscores the need to use probability-based categorizations such as probable and possible infection.
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Pediatr Crit Care Me · May 2005
A critical appraisal of a systematic review: Sokol J, Jacob SE, Bohn D: Inhaled nitric oxide for acute hypoxemic respiratory failure in children and adults. Cochrane Database Syst Rev 2003 (1): CD002787.
To review the findings and discuss the implications of the use of inhaled nitric oxide for acute hypoxemic respiratory failure in patients beyond the neonatal period. ⋯ There is insufficient evidence to determine whether inhaled nitric oxide is beneficial or harmful for acute hypoxemic respiratory failure in children and adults. While awaiting further studies to prove its benefit, inhaled nitric oxide should not either be recommended as a standard management or excluded for the treatment of acute hypoxemic respiratory failure.