Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2013
Randomized Controlled TrialThe role of different anesthetic techniques in altering the stress response during cardiac surgery in children: a prospective, double-blinded, and randomized study.
Our goal was to evaluate the role of three anesthetic techniques in altering the stress response in children undergoing surgery for repair of congenital heart diseases utilizing cardiopulmonary bypass in the setting of fast tracking or early tracheal extubation. Furthermore, we wanted to evaluate the correlation between blunting the stress response and the perioperative clinical outcomes. ⋯ The use of low-dose fentanyl was associated with the greatest stress response, most coagulopathy, and highest transfusion requirement among our cohorts. Higher dose fentanyl demonstrated more favorable blunting of the stress response. When compared with low-dose fentanyl alone, the addition of dexmedetomidine improved the blunting of the stress response, while achieving better postoperative pain control.
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Pediatr Crit Care Me · Jun 2013
Quality metrics in neonatal and pediatric critical care transport: a consensus statement.
The transport of neonatal and pediatric patients to tertiary care medical centers for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. Accurate assessment of quality indicators and patient outcomes requires the use of a standard language permitting comparisons among transport programs. No consensus exists on a set of quality metrics for benchmarking transport teams. The aim of this project was to achieve consensus on appropriate neonatal and pediatric transport quality metrics. ⋯ This project demonstrates that quality metrics can be achieved through consensus building and provides the foundation for benchmarking among neonatal and pediatric transport programs and quality improvement projects.