Pediatr Crit Care Me
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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
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
ReviewIs hyperglycemia really harmful? A critical appraisal of "Persistent hyperglycemia in critically ill children" by Faustino and Apkon (J Pediatr 2005; 146:30-34).
To review the findings and to discuss the implications of hyperglycemia in critically ill children. ⋯ This study adds to the growing body of knowledge that associates the timing, intensity, duration, and variability of glycemia with outcomes in critically ill children. However, its limitations restrict drawing causal relationships and prevents insights regarding therapy.
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Pediatr Crit Care Me · Sep 2007
Randomized Controlled Trial Comparative StudySelective medicated (normal saline and exogenous surfactant) bronchoalveolar lavage in severe aspiration syndrome in children.
To study the ability of volume-controlled ventilation and medicated (normal saline plus surfactant) bronchoalveolar lavage in aspiration to reduce the duration of intubation and improve gas exchange. ⋯ Even though this was an unblinded small clinical trial and low tidal volume strategy was not employed at an early stage after lung injury, there is some evidence that bronchoalveolar lavage with normal saline and surfactant may have clinical value in treating severe aspiration syndrome in children. More clinical studies are warranted to overcome study limitations and potential bias.