Pediatr Crit Care Me
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Pediatr Crit Care Me · Feb 2014
Observational StudySleep, Sleepiness, and Fatigue Outcomes for Parents of Critically Ill Children.
To describe sleep quantity, sleep patterns, fatigue, and sleepiness for parents of critically ill hospitalized children. ⋯ We performed a prospective observational study of 118 parents of critically ill children using objective measures of sleep and validated scales to assess fatigue and sleepiness. We found that more than a quarter of nights met criteria for acute sleep deprivation, there was considerable variability in the amount of nocturnal sleep that individual participants slept on different nights, and sleep was fragmented with a large portion of the night spent awake. Future research should focus on interventions that improve parents' ability to return to sleep upon awakening and maintain regular sleep-wake schedules.
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Pediatr Crit Care Me · Feb 2014
Outcome of Pediatric Acute Myeloid Leukemia Patients Receiving Intensive Care in the United States.
Children with acute myeloid leukemia are at risk for sepsis and organ failure. Outcomes associated with intensive care support have not been studied in a large pediatric acute myeloid leukemia population. Our objective was to determine hospital mortality of pediatric acute myeloid leukemia patients requiring intensive care. ⋯ Pediatric patients with acute myeloid leukemia frequently required intensive care resources, with mortality rates substantially lower than previously reported. Mortality also decreased over the time studied. Pediatric acute myeloid leukemia patients with sepsis who required intensive care had a mortality comparable to children without oncologic diagnoses; however, overall mortality and mortality for each category of organ failure studied was higher for the acute myeloid leukemia cohort compared with the nononcology cohort.
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Pediatr Crit Care Me · Feb 2014
Clinical Trial Observational StudyValidation of an Ultrasound Dilution Technology for Cardiac Output Measurement and Shunt Detection in Infants and Children.
To validate cardiac output measurements by ultrasound dilution technology (COstatus monitor) against those obtained by a transit-time ultrasound technology with a perivascular flow probe and to investigate ultrasound dilution ability to estimate pulmonary to systemic blood flow ratio in children. ⋯ The COstatus monitor is a reliable technique to measure cardiac output in children with high sensitivity and specificity for detecting the presence of shunts.
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Pediatr Crit Care Me · Feb 2014
Assessment of Hemoglobin Threshold for Packed RBC Transfusion in a Medical-Surgical PICU.
Results of a large multicenter randomized clinical trial published in 2007 demonstrated no benefit in using a liberal versus conservative RBC transfusion threshold in stable critically ill children. Using the conservative threshold decreased the number of RBC transfusions without increasing adverse outcomes. We aimed to determine if wide dissemination of this evidence altered the hemoglobin threshold used for RBC transfusions in our pediatric medical-surgical ICU. ⋯ Although transfusion thresholds in potentially stable critically ill children in our PICU significantly decreased after dissemination of best available evidence, 71% of patients were transfused at a hemoglobin threshold more than 7 g/dL.
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Pediatr Crit Care Me · Feb 2014
Observational StudyPostoperative Neutrophil Gelatinase-Associated Lipocalin Predicts Acute Kidney Injury After Pediatric Cardiac Surgery.
We investigated the temporal pattern and predictive value of neutrophil gelatinase-associated lipocalin for early identification of acute kidney injury in children undergoing cardiac surgery. ⋯ Urine neutrophil gelatinase-associated lipocalin is a predictive biomarker for acute kidney injury after pediatric cardiac surgery, and it may permit earlier intervention that improves outcome of acute kidney injury. Urine neutrophil gelatinase-associated lipocalin normalized to urine creatinine improves the prediction of acute kidney injury severity but offers no advantage in acute kidney injury diagnosis.