Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2010
ReviewDevelopmental neurotoxicity of sedatives and anesthetics: a concern for neonatal and pediatric critical care medicine?
To evaluate the currently available evidence for the deleterious effects of sedatives and anesthetics on developing brain structure and neurocognitive function. ⋯ Neuronal cell death after neonatal exposure to sedatives and anesthetics has been clearly demonstrated in developing animal models. Although the relevance for human medicine remains speculative, the phenomenon's serious implications for public health necessitate further preclinical and clinical studies. Intensivists using sedatives and anesthetics in neonates and infants need to stay informed about this rapidly emerging field of research.
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Pediatr Crit Care Me · Mar 2010
Comparative StudyConnecting multiple low-flow intravenous infusions in the newborn: problems and possible solutions.
To compare the efficiency of a stopcock system and a newly designed device to titrate low-flow infusions to critically ill infants. ⋯ When using the conventional stopcock array to titrate low-rate infusions, significant delays were observed. A device designed specifically for infusions in infants may substantially improve this system.
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Pediatr Crit Care Me · Mar 2010
Impact of syringe size on the performance of infusion pumps at low flow rates.
To evaluate the impact of syringe size on start-up delay and the time to reach 50% and 90% of target flow rates, using two commercially available syringe infusion pumps at infusion rates of < or =1 mL/hr. ⋯ Our findings demonstrate a clinically relevant impact of syringe size on syringe infusion pump performance at low flow rates. The time to reach 50% and 90% of target flow are significantly longer, using the 50-mL syringe compared with the 10-mL syringe, and the time to reach 50% of target flow is independent of the longer start-up delay. Based on our findings, we speculate that smaller syringe sizes and higher infusion rates are preferable for continuous drug infusions, particularly when prompt establishment of the drug effect is critical.
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Pediatr Crit Care Me · Mar 2010
Intrahospital transport of children on extracorporeal membrane oxygenation: indications, process, interventions, and effectiveness.
To evaluate indications, process, interventions, and effectiveness of patients undergoing intrahospital transport. Critically ill patients supported with extracorporeal membrane oxygenation are transported within the hospital to the radiology suite, cardiac catheterization suite, operating room, and from one intensive care unit to another. No studies to date have systematically evaluated intrahospital transport for patients on extracorporeal membrane oxygenation. ⋯ Although transporting patients on extracorporeal membrane oxygenation is labor intensive and requires extensive logistic support, it can be carried out safely in experienced hands and it can result in important therapeutic and diagnostic yields. To our knowledge, this is the first study designed to evaluate safety and efficacy of intrahospital transport for patients receiving extracorporeal membrane oxygenation support.
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Pediatr Crit Care Me · Mar 2010
Risk factors for healthcare-associated infection in a pediatric intensive care unit.
Identify risk factors for first-onset healthcare-associated infection (HAI) in a pediatric intensive care unit (PICU). ⋯ Efforts toward a reduction in the exposure to extrinsic risk factors should be made, as each of these factors separately explains 30% of the risk of HAI. Interventions directed at processes related to the use of a ventilator and limitations on its duration of use should be a priority in HAI control strategies, as each day of ventilator use increases the risk of HAI.