Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2010
Acute lung injury in children: therapeutic practice and feasibility of international clinical trials.
To describe mechanical ventilation strategies in acute lung injury and to estimate the number of eligible patients for clinical trials on mechanical ventilation management. In contrast to adult medicine, there are few clinical trials to guide mechanical ventilation management in children with acute lung injury. ⋯ Our study reveals inconsistent mechanical ventilation practice and use of adjunctive therapies in children with acute lung injury. Pediatric clinical trials assessing mechanical ventilation management are needed to generate evidence to optimize outcomes. We estimate that a large number of centers (∼60) are needed to conduct such trials; it is imperative, therefore, to bring about international collaboration.
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Pediatr Crit Care Me · Nov 2010
Comment Case ReportsNovel pH1N1 viral cardiomyopathy requiring veno-venous extracorporeal membrane oxygenation.
To report a case of pH1N1 viral infection presenting as heart failure requiring mechanical extracorporeal life support. ⋯ Patients with pH1N1 may present in profound heart failure in addition to respiratory failure. Extracorporeal membrane oxygenation may play an important role in managing these complex patients.
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Pediatr Crit Care Me · Nov 2010
Predictive factors for the outcome of noninvasive ventilation in pediatric acute respiratory failure.
To identify success and failure prognostic signs of noninvasive ventilation in pediatric acute respiratory failure. Noninvasive ventilation constitutes an alternative treatment for pediatric acute respiratory failure. However, tracheal intubation should not be delayed when considered necessary. ⋯ Modifications in a patient's respiratory assistance were made depending on the clinical, blood gas, and radiologic evolution of the patient. Mean airway pressure and Fio2 values of >11.5 and 0.6, respectively, predict failure and possibly set the limit above the patient's risk of delayed intubation increases.
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Pediatr Crit Care Me · Nov 2010
CommentGlucose variability and survival in critically ill children: allostasis or harm?
To assess whether individual blood glucose variability in critically ill children is associated with increased mortality and to define the temporal patterns of blood glucose variability during critical illness in children. ⋯ Glucose variability is common in critically ill children and is associated with increased mortality. Whereas early alterations in blood glucose may represent allostasis, later fluctuations in blood glucose may represent an alteration of autoregulation with resulting higher mortality. Control of variability may need to be incorporated into glycemic control regimens.
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Pediatr Crit Care Me · Nov 2010
CommentBrain tumor resection in children: neurointensive care unit course and resource utilization.
To describe the pediatric intensive care unit (PICU) course and resource utilization for children with brain tumor resection and to identify factors predicting prolonged (>1 day) PICU length of stay. After craniotomy for brain tumor resection, children recover in the PICU. A few require critical care interventions and a >24-hr length of stay. ⋯ Large intraoperative estimated blood loss and intubation on arrival may be predictive of PICU lengths of stay of >1 day for children who have had a craniotomy for brain tumor resection. Intensive care unit interventions are more common in these children.