Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2013
Acute lung injury in children--kids really aren't just "little adults".
To describe the planned aims and methodology of the Pediatric Acute Lung Injury Consensus Conference. ⋯ The importance of this effort for improving care and guiding future research in pediatric acute lung injury is clear. Despite the many epidemiologic, interventional, and outcome studies undertaken by pediatric intensivists worldwide, our understanding of this disease process is limited, and morbidity and mortality remain unacceptably high. By consolidating the knowledge and expertise of the leaders of the field of pediatric acute lung injury, we hope to develop a framework for future progress.
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Pediatr Crit Care Me · May 2013
Observational StudyAssessment of modified ultrafiltration hemodynamic impact by pressure recording analytical method during pediatric cardiac surgery.
Modified ultrafiltration is commonly used in pediatric cardiac surgery. Although its clinical benefits are currently debated, modified ultrafiltration has proved to improve mean arterial pressure in the first postoperative hours. Aim of our study was to measure cardiac index, stroke volume index, and mean arterial pressure modification before and after modified ultrafiltration by means of Pressure Recording Analytical Method. ⋯ According to Pressure Recording Analytical Method assessment, modified ultrafiltration acutely improves myocardial function, as shown by a 10% increase of systemic arterial pressure, stroke volume index, and cardiac index. This effect is more pronounced in smaller sized patients.
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Pediatr Crit Care Me · May 2013
Initial experience with single-vessel cannulation for venovenous extracorporeal membrane oxygenation in pediatric respiratory failure.
Venovenous extracorporeal membrane oxygenation has been used to provide cardiopulmonary support in critically ill infants and children. Recently, dual-lumen venovenous extracorporeal membrane oxygenation has gained popularity in the pediatric population. Herein, we report our institutional experience using a bicaval dual-lumen catheter for pediatric venovenous extracorporeal membrane oxygenation support, which has been our unified approach for venovenous extracorporeal membrane oxygenation since 2009. ⋯ This review presents the first single-institution experience with the dual-lumen Avalon cannula in pediatric patients. Preliminary results indicate that the catheter can be safely placed and has an acceptable complication profile; however, continued study within larger trials is necessary to fully ascertain the clinical profile of this catheter.
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Pediatr Crit Care Me · May 2013
Risk factors and outcomes of unplanned PICU postoperative admissions: a nested case-control study.
Although unplanned postoperative admission to PICUs (unplanned intensive care admission [UIA]) is uncommon, it might be associated with increased costs, morbidity, and mortality. However, detailed knowledge of risk factors and outcomes after UIA in children is still lacking. ⋯ Airway abnormality, anesthetic factors, and hypoxia intraoperative were risk factors associated with UIA. Although preventable events contribute significantly to unplanned PICU admissions, they constitute a room of opportunity in quality improvement programs.