Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2014
Comparative StudyHealth-Related Quality of Life in Pediatric Cardiac Extracorporeal Life Support Survivors.
To assess the health-related quality of life of children who received cardiac extracorporeal life support. We hypothesized that extracorporeal life support survivors have lower health-related quality-of-life scores when compared with a healthy sample, with children with chronic conditions, and with children who had surgery for congenital heart disease and did not receive extracorporeal life support. ⋯ Pediatric cardiac extracorporeal life support survivors showed lower health-related quality of life than healthy children, children with chronic conditions, and children with congenital heart disease who did not receive extracorporeal life support.
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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
Multicenter Study Observational StudyUse of Therapeutic Plasma Exchange in Children With Thrombocytopenia-Associated Multiple Organ Failure in the Turkish Thrombocytopenia-Associated Multiple Organ Failure Network.
Thrombocytopenia-associated multiple organ failure can lead to high mortality in critically ill children, possibly related to consequences of thrombotic microangiopathy. Plasma exchange therapy may improve thrombotic microangiopathy. The purpose of this observational cohort study is to describe whether there is an association between use of plasma exchange therapy and outcome in the Turkish thrombocytopenia-associated multiple organ failure network. ⋯ The positive association found between use of plasma exchange therapy and improved survival supports the potential of this therapy in Turkish children with thrombocytopenia-associated multiple organ failure. The positive, although less so, associated treatment effect observed after controlling for illness severity provides further rationale for performing a randomized controlled trial in the pediatric Turkish thrombocytopenia-associated multiple organ failure network. Sample size calculations call for a 100-patient trial with a pre hoc interim analysis after enrollment of 50 patients with thrombocytopenia-associated multiple organ failure.
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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.