Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2008
Hyperglycemia is associated with morbidity in critically ill children with meningococcal sepsis.
To determine the association between hyperglycemia and outcome in children ventilated for meningococcal sepsis. ⋯ There was a significant association between hyperglycemia and outcome. Our results support a trial of tight glycemic control in this group of critically ill children.
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Pediatr Crit Care Me · Nov 2008
Dexmedetomidine as the primary sedative during invasive procedures in infants and toddlers with congenital heart disease.
In this report, we describe the use of dexmedetomidine as the primary sedative agent while performing invasive procedures in infants and toddlers with congenital heart disease who are breathing spontaneously. ⋯ Our experience suggests that invasive procedures can be successfully performed in spontaneously breathing infants and toddlers with congenital heart disease using dexmedetomidine alone or in combination with low dose ketamine.
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Pediatr Crit Care Me · Nov 2008
A protocolized approach to identify and manage hyperglycemia in a pediatric critical care unit.
Hyperglycemia is a risk factor for poor outcome in critically ill patients, and glycemic control may decrease morbidity and mortality in adults. There is limited information regarding hyperglycemia and its control in pediatric intensive care. ⋯ Hyperglycemia is prevalent in pediatric intensive care units and may be effectively identified and managed using a protocolized approach.
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Pediatr Crit Care Me · Nov 2008
Case ReportsTransient ventricular dysfunction after an asphyxiation event: stress or hypoxia?
This report of a pediatric patient with acute upper airway obstruction causing asphyxiation emphasizes the need to maintain clinical suspicion for acquired myocardial dysfunction, despite the presumed role of noncardiogenic causes for pulmonary edema after an acute upper airway obstruction. ⋯ Myocardial dysfunction is rarely documented in children after an acute upper airway obstruction or an asphyxiation event. Pediatric intensivists and hospitalists should maintain a high degree of clinical suspicion and screen for possible myocardial dysfunction in the pediatric patient with an acute severe hypoxic event especially when accompanied by pulmonary edema. Prompt evaluation ensures appropriate support. Additionally, some role may exist for early adrenergic receptor blockade.
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Pediatr Crit Care Me · Nov 2008
Gas exchange and lung mechanics during high frequency ventilation in the perflubron-treated lung.
To identify the effect of perflubron on gas exchange and lung mechanics during high frequency oscillatory ventilation in an animal model. ⋯ Although PFOB-Hi compared with the control group improved oxygenation and reduced pulmonary shunt fraction only during the first pressure steps of a formal stepwise recruitment maneuver during high frequency oscillatory ventilation, this effect was not sustained during maximal recruitment. During the deflation phase, both PFOB groups were associated with worse gas exchange compared with the control group. PFOB also produced significant pulmonary hypertension in comparison with the control group.