Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2006
Comparative StudyPerformance of Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality (PIM), and PIM2 in a pediatric intensive care unit in a developing country.
To determine the discriminative ability and calibration of existing scoring systems in predicting the outcome (mortality) in children admitted to an Indian pediatric intensive care unit (PICU). ⋯ The area under the receiver operating characteristic curve for all the models evaluated was >0.8. However, all the models underpredicted mortality. The likely reasons for this could be differences in the patient profile and greater load of severity of illness being managed with lesser resources--both physical and human--and differences in the quality of care.
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Pediatr Crit Care Me · Jul 2006
Review Case ReportsNeurogenic stunned myocardium: an unusual postoperative complication.
In this report of myocardial dysfunction in a pediatric patient after a neurosurgical procedure, we highlight the need for high clinical suspicion for neurogenic stunned myocardium. ⋯ Neurogenic stunned myocardium is an uncommon event after neurosurgical procedures in children. Pediatric intensivists need to consider this diagnosis in a patient with signs of myocardial dysfunction in the neurosurgical postoperative period. The management of neurogenic stunned myocardium involves close monitoring and establishing the absence of other causes of myocardial ischemia.
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Pediatr Crit Care Me · Jul 2006
Comparative Study Controlled Clinical TrialChanges in cerebral saturation profile in response to mechanical ventilation alterations in infants with bidirectional superior cavopulmonary connection.
To document cerebral saturation in response to alterations in mechanical ventilation in infants with bidirectional superior cavopulmonary connection. ⋯ Hyperventilation can potentially cause a decrease in cerebral oxygenation and should be avoided in children with bidirectional superior cavopulmonary connection. Normoventilation and mild respiratory acidosis, however, preserve cerebral oxygenation in these patients.
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Pediatr Crit Care Me · Jul 2006
Noninvasive positive pressure ventilation: five years of experience in a pediatric intensive care unit.
To evaluate the feasibility and outcome of noninvasive positive pressure ventilation (NPPV) in daily clinical practice. ⋯ This study demonstrates the feasibility and efficacy of NPPV in the daily practice of a pediatric intensive care unit. This ventilatory support could be proposed as a first-line treatment in children with acute respiratory distress, except in those with a diagnosis of acute respiratory distress syndrome.