Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2013
Clinical TrialSildenafil exposure and hemodynamic effect after stage II single-ventricle surgery.
To determine sildenafil exposure and hemodynamic effect in children after stage II single-ventricle surgery. ⋯ Sildenafil demonstrated nonlinear exposure with high interindividual variability but was well tolerated and effectively lowered pulmonary vascular resistance index in all subjects. Sildenafil did not acutely improve myocardial performance or increase cardiac index.
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Pediatr Crit Care Me · Jul 2013
ReviewMechanisms of acute respiratory distress syndrome in children and adults: a review and suggestions for future research.
To provide a current overview of the epidemiology and pathophysiology of acute respiratory distress syndrome in adults and children, and to identify research questions that will address the differences between adults and children with acute respiratory distress syndrome. ⋯ There are significant obstacles to performing research on children with acute respiratory distress syndrome. However, epidemiologic, clinical, and animal studies suggest age-dependent differences in the pathophysiology of acute respiratory distress syndrome. In order to reduce the prevalence and improve the outcome of patients with acute respiratory distress syndrome, translational studies of inflammatory, apoptotic, alveolar fluid clearance, and repair mechanisms are needed. Understanding the differences in pathophysiologic mechanisms in acute respiratory distress syndrome between children and adults should facilitate identification of novel therapeutic interventions to prevent or modulate lung injury and improve lung repair.
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Pediatr Crit Care Me · Jul 2013
Comparative Study Clinical TrialCord blood proteins and multichannel-electroencephalography in hypoxic-ischemic encephalopathy.
To explore the association between multiple umbilical cord blood proteins and severity of hypoxic-ischemic encephalopathy as defined by continuous multichannel electroencephalography. ⋯ Cord blood interleukin-6 and interleukin-16 were associated with electrographic grade of hypoxic-ischemic encephalopathy. To predict an abnormal electroencephalography, interleukin-16 and 10-minute Apgar used in combination performed better than current markers.
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Pediatr Crit Care Me · Jul 2013
Observational StudyThe effect of atropine on rhythm and conduction disturbances during 322 critical care intubations.
Our objectives were to describe the prevalence of arrhythmia and conduction abnormalities before critical care intubation and to test the hypothesis that atropine had no effect on their prevalence during intubation. ⋯ Atropine significantly reduced the prevalence of new arrhythmias during intubation particularly for children over 1 month of age, did not convert sinus tachycardia to ventricular tachycardia or fibrillation, and may contribute to the safety of intubation.
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Pediatr Crit Care Me · Jul 2013
Long-term survival outcomes and causes of late death in neonates, infants, and children treated with extracorporeal life support.
Extracorporeal life support is a resource-intense treatment offered to the sickest patients. We aimed to investigate long-term survival rates and late deaths. ⋯ Although the majority of deaths were early, late mortality was observed following extracorporeal life support. Late deaths were more prevalent in children with underlying complex long-term conditions, particularly heart disease and congenital diaphragmatic hernia. Evaluation of longer term survival is an important component of audit for extracorporeal life support outcomes.