Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2007
Comparative StudyTunneled central venous catheter for neonates: A simple technique for prolonged indwelling central catheters in intensive care.
To describe and evaluate a new technique to insert a 24-gauge Silastic catheter in a central vein with a subcutaneous tunneled catheter in newborns after peripherally inserted central catheter (PICC) insertion failure. ⋯ This technique is an interesting alternative when PICC insertion is not possible.
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Pediatr Crit Care Me · Jan 2007
Randomized Controlled Trial Multicenter Study Comparative StudyPilot study to determine the hemodynamic safety and feasibility of magnesium sulfate infusion in children with severe traumatic brain injury.
Magnesium sulfate is neuroprotective in preclinical models, but there are limited safety data regarding its clinical use for pediatric traumatic brain injury. We conducted a pilot study in children with severe traumatic brain injury to a) examine if magnesium sulfate decreases mean arterial pressure, decreases cerebral perfusion pressure, increases intracranial pressure, or adversely effects cardiac conduction; and b) determine the feasibility of a multiple-center trial of magnesium sulfate. ⋯ In children with severe traumatic brain injury, magnesium sulfate administration did not decrease mean arterial pressure or cerebral perfusion pressure or adversely effect cardiac conduction. Our data suggest that enrollment of brain-injured children in a therapeutic trial remains challenging. These results provide information important for clinical trials of magnesium sulfate in children with severe traumatic brain injury.
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Pediatr Crit Care Me · Jan 2007
Review Comparative StudyCritical illness polyneuropathy and myopathy in pediatric intensive care: A review.
To review the medical literature on critical illness polyneuropathy and myopathy in childhood. ⋯ Critical illness polyneuropathy and myopathy may cause significant morbidity in critically ill children. These conditions seem to be clinically and electrophysiologically similar in children and adults, but prospective studies of these entities are required to better characterize their frequency, natural history, and clinical significance in pediatric practice.
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Pediatr Crit Care Me · Jan 2007
CommentA critical appraisal of a randomized controlled trial: Willson et al: Effect of exogenous surfactant (calfactant) in pediatric acute lung injury (JAMA 2005, 293: 470-476).
To evaluate the use of exogenous surfactant in pediatric acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) in decreasing the duration of respiratory failure. ⋯ This is a well-designed study with an appropriate intention-to-treat analysis, but it is underpowered, making it difficult to identify which patients with pediatric ALI/ARDS might benefit from calfactant. Given the uncertainty of the benefits, calfactant cannot be routinely recommended in pediatric ALI/ARDS.
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Pediatr Crit Care Me · Jan 2007
Comparative StudyAdrenal status in children with septic shock using low-dose stimulation test.
There is paucity of data on the magnitude of absolute or relative adrenal insufficiency in septic shock, especially in children. We conducted a prospective study to determine the prevalence of adrenal insufficiency in children with septic shock using a low-dose Synacthen (1 microg) stimulation test. ⋯ Relative adrenal insufficiency is common in children with septic shock and is associated with catecholamine refractory shock.