Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2013
Multicenter StudyUnscheduled readmissions to the PICU: epidemiology, risk factors, and variation among centers.
To determine the rate of, and potential risk factors for, unscheduled PICU readmission and assess for variability among PICUs within the United States. ⋯ The rate of unscheduled PICU readmission was low but associated with worse outcomes. Patient and admission/discharge characteristics associated with increased risk of readmissions could be used to target high-risk populations or modifiable factors to improve outcome. Variation of risk among centers suggests room for improvement.
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Pediatr Crit Care Me · Jul 2013
Complications associated with prolonged hypertonic saline therapy in children with elevated intracranial pressure.
Safe upper limits for therapeutic hypernatremia in the treatment of intracranial hypertension have not been well established. We investigated complications associated with hypernatremia in children who were treated with prolonged infusions of hypertonic saline. ⋯ Children treated by continuous hypertonic saline infusion for intracranial hypertension whose serum sodium levels exceeded certain thresholds experienced significantly more events of acute renal failure, thrombocytopenia, neutropenia, anemia, and acute respiratory distress syndrome than those whose sodium level was maintained below these thresholds.
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Pediatr Crit Care Me · Jul 2013
Point prevalence survey of antimicrobial utilization in the cardiac and pediatric critical care unit.
To determine the rate of documented infections and prevalence of antimicrobial use among pediatric patients admitted to the PICU. To assess the appropriateness of antimicrobial prescribing according to clinical and microbiological findings, Infectious Disease Consult recommendations, and formulary guidelines. ⋯ There was a high prevalence of antimicrobial use in CCCU-PICU patients. Because a significant proportion of antimicrobial use was deemed inappropriate, interventions are required to optimize antimicrobial use in critically ill children.