Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2014
Nonrespiratory Pediatric Logistic Organ Dysfunction-2 Score Is a Good Predictor of Mortality in Children With Acute Respiratory Failure.
Multiple organ dysfunction, not respiratory failure, is the major cause of death in children with acute lung injury or acute respiratory distress syndrome. This study was undertaken to estimate the predictive value of death of the nonrespiratory Pediatric Logistic Organ Dysfunction-2 in children with acute respiratory failure. ⋯ Our study demonstrates that the nonrespiratory Pediatric Logistic Organ Dysfunction-2 score of the entire PICU stay is highly predictive of death in children with acute respiratory failure of whom 94.3% were invasively ventilated. The nonrespiratory Pediatric Logistic Organ Dysfunction-2 score could represent the nonrespiratory organ failure definition tool whose development was recommended in the international expert recommendations on pediatric acute respiratory distress syndrome.
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Pediatr Crit Care Me · Sep 2014
Multicenter StudyRisk Factors for Acquiring Functional and Cognitive Disabilities During Admission to a PICU.
To describe the risk factors for acquiring functional or cognitive disabilities during admission to a PICU. ⋯ We identified a subset of patients whose potential for acquiring global functional and cognitive disability during admission to the PICU is high. This population may benefit from interventions that could mitigate this risk and from focused follow-up after discharge from the PICU.
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Pediatr Crit Care Me · Sep 2014
Development of Learning Objectives and a Validated Testing Tool for Management of Pediatric Mechanical Ventilation.
Graduate medical education is shifting toward an outcome-based paradigm, where physicians are evaluated for competency using well-defined criteria. Our aim was to learning objectives and a testing tool to assess competency in the management of mechanical ventilation for infants, children, and adolescents and to verify that the test was reliable and valid. ⋯ This is the first description of specific learning objectives for management of pediatric mechanical ventilation and the first validated and reliable testing tool for assessing knowledge. This tool could be used by fellowship programs to assess fellow competency and identify knowledge gaps in this area prior to completion of training. Further work must be done to determine the criteria for determination of competency.
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Pediatr Crit Care Me · Sep 2014
A Stepwise Enteral Nutrition Algorithm for Critically Ill Children Helps Achieve Nutrient Delivery Goals.
To evaluate the impact of implementing an enteral nutrition algorithm on achieving optimal enteral nutrition delivery in the PICU. ⋯ The implementation of an enteral nutrition algorithm significantly improved enteral nutrition delivery and decreased reliance on parenteral nutrition in critically ill children. Energy intake goal was reached earlier in a higher proportion of patients.
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Pediatr Crit Care Me · Sep 2014
Biomarkers S100B and Neuron-Specific Enolase Predict Outcome in Hypothermia-Treated Encephalopathic Newborns.
To evaluate if serum S100B protein and neuron-specific enolase measured during therapeutic hypothermia are predictive of neurodevelopmental outcome at 15 months in children with neonatal encephalopathy. ⋯ Serum S100B and neuron-specific enolase levels in babies with neonatal encephalopathy are associated with neurodevelopmental outcome at 15 months. These putative biomarkers of brain injury may help direct care during therapeutic hypothermia.