Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2009
Clinical TrialManagement of hyperglycemia in the pediatric intensive care unit; implementation of a glucose control protocol.
To evaluate a stepwise nurse-driven glucose control protocol for the treatment of hyperglycemia in critically ill pediatric patients. ⋯ The use of a stepwise nurse-driven glucose control protocol resulted in normoglycemia within 12 hrs for 94% of the children involved. Episodes of severe hypoglycemia did not occur. We conclude that the glucose control protocol is effective in treating hyperglycemia in critically ill children. Further studies are necessary to assess safety before the protocol could also be implemented in other pediatric intensive care units.
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Pediatr Crit Care Me · Nov 2009
Multicenter StudyLonger-term psychiatric adjustment of children and parents after meningococcal disease.
To ascertain whether increases in psychological symptoms in children and parents after meningococcal disease are sustained over time, and to examine the psychosocial and illness associations of 12-mo psychological outcome. ⋯ Admission to the hospital with meningococcal disease is followed by an increase in psychological symptoms in children at home, some of which are persistent and impairing, and by continuing posttraumatic stress symptoms in a proportion of children and parents. Psychosocial (pre- and postmorbid) factors predict problems at 12-mo follow-up.
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Pediatr Crit Care Me · Nov 2009
ReviewUltrasound examination of the lungs in the intensive care unit.
Lung ultrasound is increasingly used in the critically ill adult. It allows prompt management based upon reproducible data and generates fewer computed tomography (CT) examinations, therefore decreasing irradiation, delays, cost, and discomfort to the patient. The aim of this article is to describe the value of ultrasound for lung imaging in the critically ill and state our experience in neonates. ⋯ The standardized signs assessed in the adult are also found in the critically ill neonate, meaning a potential use in this field. Awaiting confirmatory CT studies, lung ultrasound can be taken into consideration as a possible bedside tool for completing bedside radiography.
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Pediatr Crit Care Me · Nov 2009
Comparative StudyLung contusion in children--early computed tomography versus radiography.
To investigate, in children, the correlation between the extent of lung contusion as detected on early radiologic examination (chest radiograph [CXR] and/or thoracic computed tomography [TCT]) and subsequent clinical outcome measures. ⋯ The severity of lung contusion determined by CXR, but not TCT, correlates with impairment of oxygenation, CO2 exchange, and duration of ventilatory support.
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Pediatr Crit Care Me · Nov 2009
Parental anxiety and medical comprehension within 24 hrs of a child's admission to the pediatric intensive care unit*.
Admission of a child to the pediatric intensive care unit (PICU) can create high-parental anxiety. The authors examined the factors that contribute to parental anxiety and the effect of parental anxiety on comprehension of medical information within 24 hrs of a child's admission to the PICU. The physician's recognition of parental anxiety related to their child's hospitalization was also evaluated. ⋯ Parental anxiety is high following a child's admission to the PICU. Physicians failed to recognize high-parental anxiety in nearly one third of the parents. Despite the high anxiety associated with a child's admission to the PICU, parents seem to understand their children's medical issues within the first 24 hrs.