Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2016
Review2016 Update for the Rogers' Textbook of Pediatric Intensive Care: Recognition and Initial Management of Shock.
To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. ⋯ Research efforts in pediatric shock have largely centered on pediatric septic shock, with significant progress in the understanding of sepsis epidemiology, the use of extracorporeal therapies in critically ill children with sepsis, the role of hyperlactatemia and risk stratification in pediatric septic shock, and the impact of bundled care for pediatric sepsis, including evaluation of individual bundle elements such as the optimal timing of antibiotic administration and vasoactive medication choice. A consistent theme in the literature is the beneficial role of a bundled approach to septic shock recognition and management to improve both care and outcomes.
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Pediatr Crit Care Me · Nov 2016
ReviewThe Utility of Brain Natriuretic Peptide in Pediatric Cardiology: A Review.
The aim of this article is to evaluate the clinical utility of brain natriuretic peptide in pediatric patients, examining the diagnostic value, management, and prognostic relevance, by critical assessment of the literature. ⋯ Brain natriuretic peptide assessment is a reliable test to diagnose significant structural or functional cardiovascular disease in children. In the integrated follow-up of these cases, several physiologic and clinical variables must be considered; brain natriuretic peptide may be an additional helpful marker. Nevertheless, larger prospective studies are warranted to elucidate the true prognostic value of brain natriuretic peptide in pediatric patients.
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Pediatr Crit Care Me · Nov 2016
Double-Blind Randomized Clinical Trial Comparing Dopamine and Epinephrine in Pediatric Fluid-Refractory Hypotensive Septic Shock.
We compared efficacy of dopamine and epinephrine as first-line vasoactive therapy in achieving resolution of shock in fluid-refractory hypotensive cold septic shock. ⋯ Epinephrine is more effective than dopamine in achieving resolution of fluid-refractory hypotensive cold shock within the first hour of resuscitation and improving organ functions.
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Pediatr Crit Care Me · Nov 2016
Comparative StudyEnterovirus D68 in Critically Ill Children: A Comparison With Pandemic H1N1 Influenza.
In 2014, the Unites States experienced an outbreak of enterovirus D68 associated with severe respiratory illness. The clinical characteristics associated with severe illness from enterovirus D68 during this outbreak compared with those associated with the 2009 H1N1 influenza virus outbreak are unknown. ⋯ Critically ill children with enterovirus D68 were more likely to present with reactive airway disease exacerbations, whereas children with H1N1 influenza were more likely to present with pneumonia. Compared with the pandemic H1N1 influenza outbreak, the enterovirus D68 outbreak resulted in more children requiring admission to the ICU, but was associated with less severe outcomes.
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Pediatr Crit Care Me · Nov 2016
Hospital Volume and Mortality in Mechanically Ventilated Children: Analysis of a National Inpatient Database in Japan.
To evaluate the relationship between annual hospital volume of mechanical ventilation in children and mortality. ⋯ In mechanically ventilated pediatric patients divided by hospital volume quartiles, all three higher volume groups had lower mortality than the lowest volume group.