Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2013
Multicenter Study Observational StudyA Comparison of Quality Improvement Practices at Adult and Pediatric Trauma Centers*
Quality assurance practices are structured performance improvement and patient safety processes designed to continuously monitor, evaluate, and improve the performance of a trauma program. These practices are integral in the provision of quality injury care, and yet no comprehensive description of existing quality improvement practices used by pediatric trauma centers is available. Therefore, we compared the quality improvement programs used in adult and pediatric trauma centers by performing a reanalysis of our recent survey of trauma quality improvement practices in Canada, United States, Australia, and New Zealand. ⋯ Opportunities for the improvement of pediatric quality improvement programs exist including a need to determine the optimal structure for trauma quality improvement, develop patient-centered quality indicators of injury care, measure long-term outcomes, and create measures of secondary injury prevention.
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Pediatr Crit Care Me · Oct 2013
Randomized Controlled Trial Clinical TrialPatient-Ventilator Asynchrony During Noninvasive Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist in Infants and Children.
To document the prevalence of asynchrony events during noninvasive ventilation in pressure support in infants and in children and to compare the results with neurally adjusted ventilatory assist. ⋯ Asynchrony events are frequent during noninvasive ventilation with pressure support in infants and in children despite adjusting the cycling-off criterion. Compared with pressure support, neurally adjusted ventilator assist allows improving patient-ventilator synchrony by reducing trigger delay and the number of asynchrony events. Further studies should determine the clinical impact of these findings.
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Pediatr Crit Care Me · Oct 2013
Multicenter StudyHospitalizations of Children With Neurologic Disorders in the United States.
Although neurologic disorders are among the most serious acute pediatric illnesses, epidemiologic data are scarce. We sought to determine the scope and outcomes of children with these disorders in the United States. ⋯ Children with neurologic diagnoses account for a disproportionate amount of ICU stays and deaths compared with children hospitalized for other reasons.
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Pediatr Crit Care Me · Oct 2013
Observational StudyImproving Delivery of Continuous Renal Replacement Therapy: Impact of a Simulation-Based Educational Intervention.
To describe our experience with transitions in both nursing model and educational training program for delivery of continuous renal replacement therapy. There have been very few comparisons between different care and educational models, and the optimal approach remains uncertain. In particular, we evaluated our experience with introducing a simulation-based educational model. ⋯ We report on the impact of transitioning between different educational programs for continuous renal replacement therapy, specifically with the introduction of a simulation-based approach. We observed a significant and sustained improvement in the delivery of continuous renal replacement therapy as demonstrated by a marked increase in filter lifespan.
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Pediatr Crit Care Me · Oct 2013
Observational StudyAssociation of Human Beta-Defensin-2 Serum Levels and Sepsis in Preterm Neonates*
To determine human beta-defensin-2 levels in term and preterm neonates at birth and to evaluate its impact on sepsis. ⋯ Preterm neonates show lower human beta-defensin-2 levels in cord blood compared with term neonates. Low human beta-defensin-2 levels in preterm neonates might be associated with an increased risk of late-onset sepsis.