Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2012
Randomized Controlled Trial Multicenter Study Comparative StudyTemperature profile and outcomes of neonates undergoing whole body hypothermia for neonatal hypoxic-ischemic encephalopathy.
Decreases below the target temperature were noted among neonates undergoing cooling in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Trial of whole body hypothermia for neonatal hypoxic-ischemic encephalopathy. ⋯ Term infants with a lower birth weight are at risk for decreasing temperatures of <32.0°C while undergoing body cooling using a servo-controlled system. This information suggests extra caution during the application of hypothermia as these lower birth weight infants are at risk for overcooling. Our findings may assist in planning additional trials of lower target temperature for neonatal hypoxic-ischemic encephalopathy.
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Pediatr Crit Care Me · Jan 2012
Randomized Controlled Trial Multicenter Study Comparative StudyFirst intention high-frequency oscillatory and conventional mechanical ventilation in premature infants without antenatal glucocorticoid prophylaxis.
Data comparing the effectiveness of high-frequency oscillatory ventilation and of conventional mechanical ventilation in the treatment of respiratory distress syndrome of very low birth weight infants are, to date, still matter of debate. We investigated the effects of first intention high-frequency oscillatory ventilation or conventional mechanical ventilation support on selected primary and secondary outcomes in very low birth weight infants complicated by respiratory distress syndrome in which antenatal glucocorticoid prophylaxis was not performed. ⋯ We found that high-frequency oscillatory ventilation in very low birth weight infants without antenatal glucocorticoid prophylaxis reduced the need of ventilatory support, surfactant therapy, and reintubation, and shortened neonatal intensive care unit and hospital stay, thus reducing unit and hospital costs. These data would support the usefulness of first intention high-frequency oscillatory ventilation strategy in managing in a selected population, such as very low birth weight newborns complicated by severe respiratory distress syndrome not antenatally treated with glucocorticoids.
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Pediatr Crit Care Me · Jan 2012
Comparative StudyFever control and application of hypothermia using intravenous cold saline.
To describe the use and feasibility of cold saline to decrease body temperature in pediatric neurocritical care. ⋯ Cold saline was an effective method of reducing temperature in children with acute brain injury. This approach can be considered to treat fever or to induce hypothermia. A prospective study comparing safety and efficacy vs. other cooling measures should be considered.
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Pediatr Crit Care Me · Jan 2012
Comparative StudyTargeted interventions improve shared agreement of daily goals in the pediatric intensive care unit.
To improve communication during daily rounds using sequential interventions. ⋯ Shared agreement of patients' daily goals among key healthcare providers can be increased through process-oriented interventions. Improved agreement will potentially lead to improved quality of patient care and reduced medical errors.
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Pediatr Crit Care Me · Jan 2012
Comparative StudyNeutrophil gelatinase-associated lipocalin levels during extracorporeal membrane oxygenation in critically ill children with congenital heart disease: preliminary experience.
To evaluate diagnostic and prognostic significance of neutrophil gelatinase-associated lipocalin during extracorporeal membrane oxygenation in children with congenital heart disease. ⋯ Neutrophil gelatinase-associated lipocalin levels at the first extracorporeal membrane oxygenation day may have predictive value for continuous venovenous hemofiltration. During the course of extracorporeal membrane oxygenation support, creatinine levels were normalized in patients with acute kidney injury undergoing continuous venovenous hemofiltration; in these patients, neutrophil gelatinase-associated lipocalin levels may provide further information on kidney injury.