Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2011
Survivors of septic shock caused by Neisseria meningitidis in childhood: psychosocial outcomes in young adulthood.
To investigate long-term psychosocial outcomes in young adults who survived septic shock caused by Neisseria meningitidis (meningococcal septic shock) during childhood. ⋯ Despite favorable outcomes for the majority of meningococcal septic shock patients in the long term, an important minority (5% to 20%) still struggles with ongoing problems as to behavioral/emotional problems, intellectual functioning, biographical characteristics, and illness-related physical or social consequences.
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Pediatr Crit Care Me · Nov 2011
Randomized Controlled TrialRandomized controlled trial for intermittent versus continuous propofol sedation for pediatric brain and spine magnetic resonance imaging studies.
Intermittent bolus propofol is an effective agent for pediatric magnetic resonance imaging sedation but requires constant vigilance and dose titration. Magnetic resonance imaging-compatible infusion pumps may make it possible to continuously infuse propofol, achieving a steady level of sedation at a lower total dose. This study investigates total propofol dose, recovery time, and magnetic resonance image quality in children receiving intermittent vs. continuously infused propofol sedation in children undergoing brain and spine magnetic resonance imaging studies. ⋯ Compared to intermittent bolus dosing, continuous propofol infusion provides lesser dose exposure without impacting recovery time or quality of the magnetic resonance imaging study.
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Pediatr Crit Care Me · Nov 2011
Prediction of extubation outcome in preterm infants by composite extubation indices.
To determine whether composite extubation indices can predict extubation outcome in preterm infants. ⋯ Composite extubation indices such as the diaphragmatic pressure-time index and the noninvasive respiratory muscle pressure-time index can accurately predict extubation outcome in preterm neonates.
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Pediatr Crit Care Me · Nov 2011
Pediatric emergency mass critical care: the role of community preparedness in conserving critical care resources.
Public health emergencies require resources at state, regional, federal, and often international levels; however, community preparedness is the crucial first step in managing these events and mitigating their consequences, particularly for children. Community preparedness can be optimized through system-wide planning that includes integrating multiple points of contact, such as the community, prehospital care, health facilities, and regional level of care assets.Citizen readiness, call centers, alternate care facilities, emergency medical services, and health emergency operations centers linked to community incident command systems should be considered as important options for delivery of population-based care. Early collaboration between pediatric clinicians and public health authorities is essential to ensure that pediatric needs are addressed in community preparedness for mass critical care events. ⋯ The Pediatric Emergency Mass Critical Care Task Force recommends active promotion of programs to ensure an informed citizenry; education of children and families in Centers for Disease Control and Prevention community mitigation strategies; emphasis on community-level preparedness empowering the public to provide self care; use of 9-1-1 telephone triage with pre-established protocols and in coordination with emergency medical services; and advocacy for healthcare coalitions and other creative operational concepts that provide guidance and protocols for care of the pediatric population.
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Pediatr Crit Care Me · Nov 2011
Effect on work of breathing of different continuous positive airway pressure devices evaluated in a premature neonatal lung model.
A device for the application of continuous positive airway pressure to switch injected breathing gas to the outlet during expiration, known as Infant Flow, claims to reduce work of breathing and peak pressure change. So far the Infant Flow system has been investigated in lung models with tidal volumes of not <12 mL. However, premature neonates below 1000 g of weight generate a tidal volume of approximately 4 mL only. The aim of this study was to compare work of breathing and peak pressure change of the Infant Flow and another system that uses nasal prongs, Baby Flow, with conventional continuous positive airway pressure delivered by a pharyngeal tube. ⋯ Peak pressure change and work of breathing were decreased by Baby Flow and Infant Flow systems, even under conditions of leak.