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
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
Case ReportsInternal mammary artery injury after central venous catheterization.
We describe an infrequent but potentially lethal complication: an iatrogenic injury of the internal mammary artery after central venous catheterization. ⋯ Central venous catheter placement in the intrathoracic vein may cause potentially lethal complications in the form of an injury to the internal mammary artery. Hypotension during or immediately after the procedure should be a warning of a serious adverse event, such as massive hemothorax, that may compromise life. Adequate drainage of the pleural cavity may not completely relieve vascular compression if some of the bleeding from an injured internal mammary artery is extrapleural. Early diagnosis and treatment by selective embolization of the injured vessel in interventional radiology is the first therapeutic choice and may be life saving.
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Pediatr Crit Care Me · Sep 2007
Extracorporeal membrane oxygenation for refractory septic shock in children: one institution's experience.
To report our institutional experience of venoarterial extracorporeal membrane oxygenation (ECMO) in children with septic shock and circulatory collapse. ⋯ Extracorporeal membrane oxygenation can be safely used to resuscitate and support children with sepsis and refractory shock. Sepsis and multiorgan failure should not be considered a contraindication to ECMO. This study adds support to existing guidelines.
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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.