Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2005
ReviewParent satisfaction in pediatric intensive care: a critical appraisal of the literature.
To assess the content and characteristics of satisfaction surveys for the development of a parent satisfaction questionnaire to improve clinical practice in pediatric intensive care. ⋯ The use of parent satisfaction surveys in pediatric intensive care is not well documented. Family-centered care has become widely accepted as an important issue in quality of care, and satisfaction surveys are a valuable resource for measuring and improving clinical practice. Parent satisfaction surveys need to be developed based on the needs and experiences of parents, and emphasis should be put on methodologic issues to have the results accepted as valid and effective for possible changes in clinical practice.
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To review the findings and discuss implications of studies on high-dose epinephrine (0.1 mg/kg) during cardiopulmonary resuscitation in children. ⋯ There is no benefit from the use of high-dose epinephrine in pediatric cardiopulmonary resuscitation. There is potential harm from such dosing. The cumulative evidence against the use of high-dose epinephrine during pediatric cardiopulmonary resuscitation is strong.
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Pediatr Crit Care Me · Sep 2005
Comparative StudyHemolytic characteristics of three commercially available centrifugal blood pumps.
As compared with traditional extracorporeal roller-occlusion blood pumps, nonocclusive centrifugal pumps offer the benefits of requiring a smaller circuit surface area and, thus, a smaller prime volume. However, centrifugal blood pumps have been reported to generate unacceptable levels of hemolysis. We hypothesize that the newer generation centrifugal pumps have an incidence of hemolysis similar to the traditional roller head pumps and, thus, could be used for extracorporeal membrane oxygenation circuits. ⋯ These data are encouraging for the development of a low-prime, mobile neonatal extracorporeal membrane oxygenation circuit using centrifugal pump technology.
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Nesiritide (synthetic B-type natriuretic peptide) has been shown to be effective in the management of acute decompensated heart failure in adults. The role of nesiritide in pediatric heart failure has not been examined. In the present study, we reviewed our initial experience with nesiritide in children with primary heart failure or low cardiac output after heart surgery. ⋯ Nesiritide is well tolerated in children with heart failure and is associated with improved diuresis. Further prospective studies will be needed to compare nesiritide with other vasoactive agents and examine the cost-efficacy of this therapy.
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Pediatr Crit Care Me · Sep 2005
Comparative Study Controlled Clinical TrialComparison of temporal artery thermometer to standard temperature measurements in pediatric intensive care unit patients.
To determine the accuracy of noninvasive infrared temporal artery thermometry compared with rectal, axillary, and pulmonary artery catheter measurements in pediatric intensive care patients, and to determine whether temporal artery temperatures are affected by circulatory shock or by vasopressor use. We hypothesized that temporal artery temperatures do not differ from axillary and rectal temperatures in critically ill children, but temporal artery accuracy is decreased by shock or vasopressor use. ⋯ Temporal artery and axillary temperature measurements showed variability to rectal temperatures but had marked variability in febrile children. Neither was sufficiently accurate to recommend replacing rectal or other invasive methods. As temporal artery and axillary provide similar accuracy, temporal artery thermometers may serve as a suitable alternative for patients in whom invasive thermometry is contraindicated.