Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2011
Comparative StudyComparison of bedside and laboratory blood glucose estimations in critically ill children with shock.
Bedside glucometers are often used for frequent glucose measurements on capillary blood in critically ill children. However, there are concerns that capillary blood glucose estimations may not be accurate in children with shock and peripheral edema. The objective of this study was to compare simultaneously obtained laboratory values of arterial or central venous blood glucose with capillary blood glucose estimation using a glucometer in children with shock. ⋯ Capillary blood glucose estimation in children with shock was similar to the laboratory measurement in the midranges of glucose values.
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Pediatr Crit Care Me · Nov 2011
Very high serum ferritin levels are associated with increased mortality and critical care in pediatric patients.
To determine whether an elevated serum ferritin level is independently associated with mortality and receipt of critical care in pediatric patients. ⋯ In this pediatric population, with serum ferritin levels of >3000 ng/mL, there was increased risk for both receipt of critical care and subsequent death.
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Pediatr Crit Care Me · Nov 2011
Benchmarking, public reporting, and pay-for-performance: a mixed-methods survey of California pediatric intensive care unit medical directors.
We sought to assess the attitudes of pediatric intensive care unit medical directors in California regarding the need for, the validity of, and the potential impact of benchmarking, public reporting, and pay-for-performance on pediatric critical care. ⋯ Pediatric intensive care unit medical directors sometimes express contradictory opinions about the merits of shared benchmarking efforts and express concerns across a range of logistic, methodological, and policy issues. These findings raise fundamental questions about how to create clinical performance standards that facilitate quality improvement in the face of a seriously divided constituency. Further, we propose that pediatric intensive care unit medical directors play more active roles in the development, implementation, and communication of shared state-wide data collection.
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Pediatr Crit Care Me · Nov 2011
Diagnostic efficacy of activated partial thromboplastin time waveform and procalcitonin analysis in pediatric meningococcal sepsis.
A biphasic activated partial thromboplastin time waveform predicts sepsis and disseminated intravascular coagulation in adults. This has not been previously investigated in children. Our aim is to ascertain whether there are changes in the activated partial thromboplastin time waveform in children with meningococcal disease and to compare its diagnostic use with procalcitonin. ⋯ The activated partial thromboplastin time waveform is abnormal in children with meningococcal disease and may be a useful adjunct in the diagnosis and management of sepsis in children.
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Pediatr Crit Care Me · Nov 2011
Patient safety culture in a Dutch pediatric surgical intensive care unit: an evaluation using the Safety Attitudes Questionnaire.
Nowadays, the belief is widespread that a safety culture is crucial to achieving patient safety, yet there has been virtually no analysis of the safety culture in pediatric hospital settings so far. Our aim was to measure the safety climate in our unit, compare it with benchmarking data, and identify potential deficiencies. ⋯ Although on most domains the safety culture in our unit was good when compared to benchmark data, there is still room for improvement. This requires us to continue working on interventions intended to improve the safety culture, including crew resource management training, safety briefings, and senior executive walk rounds. More research is needed into the impact of creating a safety culture on patient outcomes.