Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2014
Comparative Study Observational StudyPrevalence of Burnout in Pediatric Intensivists: An Observational Comparison With General Pediatricians.
To study the prevalence of burnout in general pediatricians and pediatric intensivists and to evaluate factors that may be associated with this syndrome. ⋯ Burnout is frequent among pediatric intensivists and characterized by cumulative involvement of emotional exhaustion, depersonalization, and professional accomplishment. Earlier recognition of emotional exhaustion may be important in preventing the development of a complete burnout syndrome. Improvement in workplace characteristics and measures to improve physician resilience are entirely warranted.
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Pediatr Crit Care Me · Oct 2014
Pulmonary Deadspace and Postoperative Outcomes in Neonates Undergoing Stage 1 Palliation Operation for Single Ventricle Heart Disease.
Increased pulmonary dead space fraction (VD/VT) has been associated with prolonged mechanical ventilation after surgery for congenital heart disease. The association of VD/VT with clinical outcomes in neonates undergoing stage 1 palliation for single ventricle congenital heart disease has not been reported. We describe changes in VD/VT, differences in VD/VT based on shunt type (right ventricle to pulmonary artery conduit vs modified Blalock-Taussing shunt) and association of VD/VT with postoperative outcomes in patients undergoing stage 1 palliation. ⋯ Increased pulmonary dead space exists early after stage 1 palliation operation for single ventricle congenital heart disease. Higher VD/VT during the first 48 postoperative hours was associated with longer duration of ventilation and hospital LOS and may be a useful marker of postoperative outcomes in this population.
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Pediatr Crit Care Me · Oct 2014
Observational StudyTranscranial Doppler-Based Assessment of Cerebral Autoregulation in Critically Ill Children During Diabetic Ketoacidosis Treatment.
Impaired cerebral autoregulation may be associated with poor outcome in diabetic ketoacidosis. We examined change in cerebral autoregulation during diabetic ketoacidosis treatment. ⋯ Impaired cerebral autoregulation was common early during diabetic ketoacidosis treatment. Although the majority improved during diabetic ketoacidosis treatment, 17% of subjects had impairment between 36 and 72 hours after start of insulin therapy. The observed impaired cerebral autoregulation appears specific to the diabetic ketoacidosis process in patients with type I diabetes.
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Pediatr Crit Care Me · Oct 2014
ReviewIntegrating Palliative Care Into the PICU: A Report From the Improving Palliative Care in the ICU Advisory Board.
This review highlights benefits that patients, families and clinicians can expect to realize when palliative care is intentionally incorporated into the PICU. ⋯ Palliative care should begin at the time of a potentially life-limiting diagnosis and continue throughout the disease trajectory, regardless of the expected outcome. Although the PICU is often used for short term postoperative stabilization, PICU clinicians also care for many chronically ill children with complex underlying conditions and others receiving intensive care for prolonged periods. Integrating palliative care delivery into the PICU is rapidly becoming the standard for high quality care of critically ill children. Interdisciplinary ICU staff can take advantage of the growing resources for continuing education in pediatric palliative care principles and interventions.