Pediatr Crit Care Me
-
Pediatr Crit Care Me · Sep 2013
Randomized Controlled TrialEffect of Mechanical Cleaning of Endotracheal Tubes With Sterile Urethral Catheters to Reduce Biofilm Formation in Ventilator Patients.
To investigate the effectiveness of mechanical cleaning with sterile urethral catheters to prevent formation of biofilms on endotracheal tubes. ⋯ Mechanical cleaning with sterile urethral catheters reduced bacterial colonization, prevented formation of endotracheal tube biofilm, and reduced the occurrence of ventilator-associated pneumonia.
-
In the past decade, guidelines have been developed for the early detection and management of severe sepsis in children and neonates. However, severe sepsis continues to be a significant U.S. healthcare problem, accounting for over 720,000 annual hospitalizations. Large-scale epidemiologic studies of severe sepsis continue to be limited, particularly in children. We present data from 1995, 2000, and 2005 in seven U.S. states, examining how case mix, outcome, and resource use for pediatric severe sepsis have changed over time. ⋯ Between 1995 and 2005, the prevalence of severe sepsis in U.S. children steadily rose, due to a significant increase in the prevalence of severe sepsis in newborns.
-
Pediatr Crit Care Me · Sep 2013
Nonconvulsive Electrographic Seizures Are Common in Children With Abusive Head Trauma.
To determine the prevalence of nonconvulsive seizures in children with abusive head trauma. ⋯ Electrographic seizures and electrographic status epilepticus are common in children with abusive head trauma. Most seizures have no clinical correlate. Further study is needed to determine whether seizure identification and management improves outcome.
-
Pediatr Crit Care Me · Sep 2013
High-Flow Nasal Prong Oxygen Therapy or Nasopharyngeal Continuous Positive Airway Pressure for Children With Moderate-to-Severe Respiratory Distress?
The aim of this study was to compare the use of high-flow nasal prong oxygen therapy to nasopharyngeal continuous positive airway pressure in a PICU at a tertiary hospital; to understand the safety and effectiveness of high-flow nasal prong therapy; in particular, what proportion of children require escalation of therapy, whether any bedside monitoring data predict stability or need for escalation, and complications of the therapies. ⋯ High-flow nasal prong therapy is a safe form of respiratory support for children with moderate-to-severe respiratory distress, across a large range of diagnoses, whose increased work of breathing or hypoxemia is not relieved by standard oxygen therapy. About one quarter of all children will require escalation to another form of respiratory support. This can be predicted by simple bedside observations.
-
Pediatr Crit Care Me · Sep 2013
Mechanical Ventilation Strategies in Children With Acute Lung Injury: A Survey on Stated Practice Pattern.
The aim of this survey was to determine North American and European pediatric intensivists' knowledge and stated practice in the management of children with acute respiratory distress syndrome with regard to mechanical ventilation settings; blood gas and SO2 targets; and use of adjunctive treatments at sites where actual practice had just been assessed. ⋯ Although in theory, many pediatric intensivists agreed with adult recommendations to ventilate with lower tidal volumes and pressure limits, the Pediatric Acute Lung Injury Mechanical Ventilation data revealed that over 25% of pediatric patients with acute lung injury/acute respiratory distress syndrome at many of these practice sites were ventilated with tidal volumes above 10 mL/kg and that high positive inspiratory pressure levels (> 35 mm Hg) were often tolerated.