Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2010
Building trust through communication in the intensive care unit: HICCC.
The goal of this study was to explore the role of communication in building trust between intensivists and parents in the pediatric intensive care unit. ⋯ Communication is vital to building trust in the pediatric intensive care unit. Developed from parents' own observations and perspectives, HICCC is an accessible framework that can help doctors to remember what parents value in communication in the acute care setting. In addition, pediatric intensivists would benefit from targeted cultural competency training to reduce physician bias.
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Pediatr Crit Care Me · May 2010
Clinical implications of hepatitis A virus ribonucleic acid detection and genotyping in acute liver failure in children in Argentina.
To investigate the detection of hepatitis A virus ribonucleic acid in patients with acute liver failure and to assess if the results have any clinical implications for the evolution of acute liver failure in children. Hepatitis A infection, a vaccine-preventable disease, is an important cause of acute liver failure in children in Argentina. Universal vaccination in 1-yr-old children was implemented in June 2005. ⋯ Hepatitis A virus genotyping studies did not show any particularities, all cases were IA and, thus, apparent associations between genotype and the clinical presentation of acute liver failure could not be found.
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Pediatr Crit Care Me · May 2010
Case ReportsHome extubation by a pediatric critical care team: providing a compassionate death outside the pediatric intensive care unit.
Our objective is to present a case report of home extubation by a pediatric intensive care team in a terminally ill pediatric patient. Literature relevant to home extubation will be reviewed. The design is a case report. ⋯ Before offering home extubation to families, hospitals should prepare families for the experience and address the availability of staff to comfort parents and provide bereavement support. Medicolegal as well as cost issues for the hospital related to home extubation should be explored before the implementation of a program of this nature. This case illustrates that home extubation is a creative, compassionate, and culturally sensitive alternative to hospital-based end-of-life care involving the pediatric intensivist, transport teams, and primary care physicians.
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Pediatr Crit Care Me · May 2010
Randomized Controlled Trial Multicenter StudyCardiac arrhythmias associated with severe traumatic brain injury and hypothermia therapy.
Severe head trauma and/or severe hypothermia (< or =32 degrees C) can cause cardiac arrhythmias. Effect of moderate hypothermia (32-33 degrees C) on cardiac arrhythmias in children after severe traumatic brain injury is not well characterized. The objective is to determine the effect of moderate and short-term (24 hrs) hypothermia therapy on the incidence and severity of cardiac arrhythmias in children with severe traumatic brain injury compared with normothermic control subject using a 24-hr Holter recording. ⋯ Arrhythmias are frequent in severe pediatric traumatic brain injury. Further studies are needed to characterize the epidemiology and clinical impact of arrhythmias associated with severe pediatric head trauma and moderate hypothermia.
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Pediatr Crit Care Me · May 2010
Randomized Controlled TrialHelium/oxygen-driven albuterol nebulization in the management of children with status asthmaticus: a randomized, placebo-controlled trial.
We investigated the effect of heliox-powered albuterol therapy on hospital length of stay and clinical status in children with moderate to severe status asthmaticus. ⋯ Despite the previously demonstrated effects of heliox on improved aerosol particle delivery into the distal airways, heliox-powered nebulized albuterol therapy for children admitted to the hospital with moderate to severe status asthmaticus does not shorten hospital length of stay or hasten rates of clinical improvement when compared with air/oxygen-powered nebulized albuterol.