Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2008
Incidence of hypo- and hypercarbia in severe traumatic brain injury before and after 2003 pediatric guidelines.
To examine the incidence of severe hypocarbia (PaCO2 <30 mm Hg) in patients with severe pediatric traumatic brain injury before and after publication of the 2003 pediatric guidelines (PG). ⋯ Although PaCO2 sampling was more frequent during the post-PG period and severe hypocarbia decreased during successive study years, the incidence of severe hypocarbia remained high during the first 48 hrs after hospital admission during the post-PG period. Time to PaCO2 sampling was longer in young children and associated with more severe hypocarbia. The presence of severe hypocarbia predicted mortality.
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Pediatr Crit Care Me · Mar 2008
Glucose control, organ failure, and mortality in pediatric intensive care.
In ventilated children, to determine the prevalence of hyperglycemia, establish whether it is associated with organ failure, and document glycemic control practices in Australasian pediatric intensive care units (PICUs). ⋯ Hyperglycemia is common in PICUs, occurs early, and is independently associated with organ failure and death. However, early hyperglycemia is not associated with later or worsening organ failure. Australasian PICUs seldom use insulin.
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Pediatr Crit Care Me · Mar 2008
Pediatric organ donation: what factors most influence parents' donation decisions?
To identify factors that influence parents' decisions when asked to donate a deceased child's organs. ⋯ This study identifies several modifiable variables that influence the donation decision-making process for parents. Strategies to facilitate targeted organ donation education and higher consent rates are discussed.
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Pediatr Crit Care Me · Mar 2008
Maternal pulse oximetry perfusion index as a predictor of early adverse respiratory neonatal outcome after elective cesarean delivery.
Evidence suggests increased morbidity, in particular early neonatal respiratory complications, in newborns from elective cesarean section compared with those from vaginal delivery. No reliable maternal predictors of adverse neonatal outcome at elective cesarean section are known. Here, we prospectively tested the hypothesis that a low maternal perfusion index at the baseline phase (i.e., preanesthesia) of the elective cesarean section is a predictor of early adverse neonatal respiratory outcome. ⋯ A decreased perfusion index value in the preanesthesia phase of elective cesarean section is a maternal predictor of increased neonatal morbidity and is significantly related to subclinical placental inflammatory disease. These observations suggest the feasibility of a noninvasive pulse oximeter prenatal screening of the high-risk fetus/newborn in elective cesarean section.
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Few accurate data are available on the outcome of septic shock in the neonatal period. The objective was to describe outcome and to determine variables associated with death or adverse outcome in neonates with septic shock. ⋯ Septic shock in the neonatal period has a very poor outcome. Data underscore the extreme vulnerability of very low birth weight infants to septic shock, particularly to gram-negative species.