Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2007
Clinical TrialWeaning children from mechanical ventilation with a computer-driven system (closed-loop protocol): a pilot study.
To evaluate the applicability, tolerance, and efficacy of a closed-loop protocol to wean children from mechanical ventilation. ⋯ A closed-loop protocol was successfully used to wean children from mechanical ventilation. Further studies are required to assess the impact of this novel therapeutic strategy on the length of mechanical ventilation.
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Pediatr Crit Care Me · Sep 2007
Using pediatric advanced life support in pediatric residency training: does the curriculum need resuscitation?
The Pediatric Advanced Life Support (PALS) course is used throughout North American pediatric residency programs to provide a core pediatric resuscitation curriculum. Despite this widespread use, its effectiveness has not been formally assessed in pediatric residents. This study aimed to evaluate the PALS curriculum's effectiveness in providing pediatric residents with knowledge, skill and confidence in pediatric resuscitation. ⋯ PALS is successful in providing basic resuscitation knowledge to pediatric residents, but knowledge of critical algorithm details is not sustained. The course does not provide for the expected level of competency in relevant technical skills. Residents do not achieve the confidence to feel well prepared to provide comprehensive care to pediatric patients in cardiopulmonary arrest. These findings support the hypothesis that the PALS course alone is insufficient to provide pediatric residents with competency in cardiopulmonary resuscitation.
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Pediatr Crit Care Me · Sep 2007
Randomized Controlled TrialEffect of inhaled corticosteroid on pulmonary injury and inflammatory mediator production after cardiopulmonary bypass in children.
To determine whether inhaled steroid administration after cardiopulmonary bypass will attenuate pulmonary inflammation and improve lung compliance and oxygenation. ⋯ Cardiopulmonary bypass is associated with a pulmonary inflammatory response. Inhaled corticosteroid did not affect the pulmonary inflammatory response as measured by interleukin-6 and interleukin-8 concentrations in the lung lavage after cardiopulmonary bypass. Pulmonary mechanics and oxygenation were not improved by the use of inhaled corticosteroid.
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Pediatr Crit Care Me · Sep 2007
Randomized Controlled TrialProbiotic administration and the incidence of nosocomial infection in pediatric intensive care: a randomized placebo-controlled trial.
To evaluate the efficacy of probiotics in reducing the rates of nosocomial infection in pediatric intensive care. ⋯ The results of this preliminary investigation were unexpected but important in view of the increased use of probiotic preparations in medically fragile pediatric patients. In this randomized, placebo-controlled trial, L. rhamnosus strain GG was not shown to be effective in reducing the incidence of nosocomial infections. In fact, a statistically nonsignificant trend toward an increase in infection was seen (four vs. 11). Further studies with a larger patient population are needed to establish both safety and efficacy of probiotics in pediatric critical care.
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Pediatr Crit Care Me · Sep 2007
Comparative Study Clinical TrialPharmacokinetics of dexmedetomidine in postsurgical pediatric intensive care unit patients: preliminary study.
To characterize the pharmacokinetics of dexmedetomidine and monitor any dexmedetomidine-related adverse events in postoperative pediatric patients requiring short-term mechanical ventilation, analgesia, and sedation in the pediatric intensive care unit (PICU). ⋯ Dexmedetomidine, administered as a continuous infusion, produces consistent, predictable concentrations in children and infants. Further evaluations of the safety, efficacy, and pharmacodynamics of dexmedetomidine are warranted.