Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2011
Randomized Controlled TrialBlood transfusion is associated with prolonged duration of mechanical ventilation in infants undergoing reparative cardiac surgery.
Perioperative transfusion has adverse effects in adults undergoing cardiac surgery. We sought to investigate whether greater use of blood and blood products might be an independent predictor of prolonged postoperative recovery, indicated by duration of mechanical ventilation (DMV), after reparative infant heart surgery. ⋯ In this exploratory secondary analysis of infants undergoing two ventricular repair of congenital heart disease without aortic arch obstruction, greater intraoperative and early postoperative blood transfusion emerged as potential important risk factors for longer DMV. Future prospective clinical trials are needed to determine whether reduction in blood product administration hastens postoperative recovery after infant heart surgery.
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Pediatr Crit Care Me · Jan 2011
Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates.
To evaluate the viability and effectiveness of a simulation-based pediatric mock code program on patient outcomes, as well as residents' confidence in performing resuscitations. A resident's leadership ability is integral to accurate and efficient clinical response in the successful management of cardiopulmonary arrest (CPA). Direct experience is a contributing factor to a resident's code team leadership ability; however, opportunities to gain experience are limited by relative infrequency of pediatric arrests and code occurrences when residents are on service. ⋯ This study suggests that a simulation-based mock code program may significantly benefit pediatric patient CPA outcomes-applied clinical outcomes-not simply learner perceived value, increased confidence, or simulation-based outcomes. The use of mock codes as an integral part of residency programs could provide residents with the resuscitation training they require to become proficient in their practice. Future programs that incorporate transport scenarios, ambulatory care, and other outpatient settings could further benefit pediatric patients in prehospital contexts.
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Pediatr Crit Care Me · Jan 2011
Noninvasive ventilation in a tertiary pediatric intensive care unit in a middle-income country.
To determine the factors that predict outcome of noninvasive ventilation (NIV) in critically ill children. ⋯ NIV was a feasible strategy of respiratory support to avoid intubation in > 75% of children in this study. A higher Pediatric Risk of Mortality II score, sepsis at initiation of NIV, an abnormal respiratory rate, and a higher requirement of Fio2 may be predictive factors of NIV failure.