Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2007
Regional and central venous oxygen saturation monitoring following pediatric cardiac surgery: concordance and association with clinical variables.
To compare changes in regional cerebral or flank oxygen saturation measured by near-infrared spectroscopy with changes in central venous oxygen saturation (ScvO2) and to determine clinical variables associated with these changes. ⋯ Neither individual values nor changes in rSO2 are interchangeable measures of ScvO2 in postoperative pediatric cardiac patients. The unique relationship between changes in PaCO2 and cerebral rSO2 supports the hypothesis that cerebral near-infrared spectroscopy monitors regional cerebral oxygenation. Clinical application of this monitor must include recognition of the clinical variables that affect regional brain oxygenation.
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The climate within the United States is rapidly changing with respect to patient and family knowledge of medical error and their expectations of the events that should occur after an error. ⋯ It seems that if disclosure of medical error is made with compassion, in a timely manner, and with good communication skills both during and after the disclosure process, patients and their families are at least no more likely to seek legal action and some lawsuits may actually be avoided.
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Pediatr Crit Care Me · Mar 2007
Meta AnalysisEarly elevation of plasma von Willebrand factor antigen in pediatric acute lung injury is associated with an increased risk of death and prolonged mechanical ventilation.
Von Willebrand factor antigen (vWF-Ag) is a marker of pulmonary and systemic endothelial activation and injury. Adult studies indicate that patients with plasma vWF-Ag levels > or = 450% of control early in the course of acute lung injury (ALI) have an increased risk of death. The objective of this study was to evaluate whether vWF-Ag is elevated in the early phase of ALI in children and whether the magnitude of the increase was predictive of two important outcomes: mortality or duration of mechanical ventilation. ⋯ Early injury to the systemic and pulmonary endothelium, as measured by plasma vWF-Ag levels, is associated with an increased risk of death and prolonged mechanical ventilation in pediatric patients with ALI.
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Pediatr Crit Care Me · Mar 2007
Validity and reliability of the Behavioural Observational Pain Scale for postoperative pain measurement in children 1-7 years of age.
Pain measurement is a necessity in pain treatment but can be difficult in young children. The aim of this study was to evaluate the validity and reliability of the Behavioural Observational Pain Scale (BOPS) as a postoperative pain measurement scale for children aged 1-7 yrs. The scale assesses three elements of pain behaviors: facial expression, verbalization, and body position. ⋯ With BOPS, the caretaker can evaluate and document pain with high reliability and validity and thereby improve postoperative pain treatment in preschool children. The simple scoring system makes BOPS easy to incorporate in a postoperative unit.
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Pediatr Crit Care Me · Mar 2007
ReviewDexmedetomidine: applications in pediatric critical care and pediatric anesthesiology.
To provide a general descriptive account of the end-organ effects of dexmedetomidine and to provide an evidence-based review of the literature regarding its use in infants and children. ⋯ The literature contains reports of the use of dexmedetomidine in approximately 800 pediatric patients. Given its favorable sedative and anxiolytic properties combined with its limited effects on hemodynamic and respiratory function, there is growing interest in and reports of its use in the pediatric population in various clinical scenarios.