Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2006
Cerebral oxygenation in neonatal and pediatric patients during veno-arterial extracorporeal life support.
To observe the effects of right carotid artery ligation and variations in extracorporeal life support (ECLS) flow on regional cerebral oxygenation index (rSO2i) measured using near infrared spectroscopy. ⋯ This study demonstrated no relationship between ECLS flow and rSO2i changes during the 72-hr observation period. A brief period of cerebral oxygen desaturation of the right frontal region at the time of right carotid ligation was seen in all three study patients examined during cannulation, followed by an increased rSO2i with initiation of ECLS flow. Near infrared spectroscopy measurement may offer an important adjunct for neurologic monitoring of ECLS patients.
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Pediatr Crit Care Me · Mar 2006
Use of dexmedetomidine in children after cardiac and thoracic surgery.
In this report, we describe our experience with the use of dexmedetomidine in spontaneously breathing as well as in mechanically ventilated patients, after congenital cardiac and thoracic surgery. ⋯ Our data suggest that dexmedetomidine is a well-tolerated and effective agent for both spontaneously breathing and mechanically ventilated patients following congenital cardiac and thoracic surgery.
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Pediatr Crit Care Me · Mar 2006
Case ReportsAbdominal compartment syndrome contributing to failure of extracorporeal membrane oxygenation in an infant with congenital heart disease and sepsis.
To provide the first account of extracorporeal membrane oxygenation therapy failure secondary to abdominal compartment syndrome. ⋯ Abdominal compartment syndrome is a life-threatening condition resulting from an increase in intra-abdominal pressure that compromises abdominal organ perfusion, pulmonary function, and cardiac output. Mortality rates from abdominal compartment syndrome are as high as 60% in adults and children. This report of an infant with congenital heart disease and E. coli sepsis represents the first description of abdominal compartment syndrome that contributed to failure of extracorporeal membrane oxygenation and ultimately death. The pathophysiology, diagnosis, and treatment of abdominal compartment syndrome are also reviewed.
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To argue that that there has been a remarkable absence of discussion of the importance of parental love in the pediatric intensive care literature, and that this silence has been to the detriment of both medical and nursing pediatric intensive care practice. ⋯ Research and anecdotal literature to date have focused on the negative changes that occur in the parental role during a child's pediatric intensive care unit admission. In contrast, the love that a parent holds for his or her child is profoundly positive and stable; it is not a "role" that can be taken away or threatened. It is proposed that the recognition and acknowledgment of this love will alter the critical care encounter for parents, physicians, and nurses and result in a better understanding by the staff of parental attitudes and behaviors. This may be particularly effective in situations where it is perceived that unreasonable demands are being made for futile therapy.