Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2016
Review Practice GuidelinePediatric Cardiac Intensive Care Society 2014 Consensus Statement: Pharmacotherapies in Cardiac Critical Care Anticoagulation and Thrombolysis.
Thrombotic complications are increasingly being recognized as a significant cause of morbidity and mortality in pediatric and congenital heart disease. The objective of this article is to review the medications currently available to prevent and treat such complications. ⋯ Anticoagulants, antiplatelet agents, and thrombolytic agents are routinely used successfully in the pediatric patient with heart disease for the prevention and treatment of a wide range of thrombotic complications. Although the novel oral anticoagulants have been approved for a limited number of indications in adults, studies on the safety and efficacy of these agents in children are pending.
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Pediatr Crit Care Me · Mar 2016
Nurses' Attitudes Toward Clinical Research: Experience of the Therapeutic Hypothermia After Pediatric Cardiac Arrest Trials.
To understand factors affecting nurses' attitudes toward the Therapeutic Hypothermia After Pediatric Cardiac Arrest trials and association with approach/consent rates. ⋯ The majority of nurses had positive perceptions of the Therapeutic Hypothermia After Pediatric Cardiac Arrest trials. Institutional, colleague, and study team support and training were contributing factors. Despite increased work, nurses remained enthusiastic demonstrating that studies with intensive bedside nursing procedures are feasible. Institutions whose nurses believed hypothermia was beneficial had lower consent rates, suggesting that educating nurses on study rationale and equipoise may enhance study participation.
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Pediatr Crit Care Me · Mar 2016
Observational StudyA Novel Combined-Catheter to Monitor Left and Right Atrial Pressures: A Simple and Reliable Method for Pediatric Cardiac Surgery.
To introduce a novel combined-catheter to monitor left and right atrial pressures. ⋯ This novel combined-catheter was safe and reliable at monitoring left and right atrial pressures, and infusion involved only one catheter without the disadvantages of the traditional method. This new novel method may be particularly useful in pediatric open-heart surgery.
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Pediatr Crit Care Me · Mar 2016
Exploring the Role of Polycythemia in Patients With Cyanosis After Palliative Congenital Heart Surgery.
To understand the relationship between polycythemia and clinical outcome in patients with hypoplastic left heart syndrome following the Norwood operation. ⋯ Early polycythemia following the Norwood operation is associated with longer length of hospitalization even after controlling for blood cell transfusion practices. We hypothesize that polycythemia may be caused by hemoconcentration and used as an early marker of capillary leak syndrome.
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Pediatr Crit Care Me · Mar 2016
Pediatric Hematopoietic Stem Cell Transplant and Intensive Care: Have Things Changed?
Mortality for pediatric patients who require intensive care posthematopoietic stem cell transplant still remains high. Previously at our institution, survival rates were 44% for patients who required mechanical ventilation posthematopoietic stem cell transplant. We conducted a review of patients to identify whether there has been any improvement in survival over the past 12 years and to identify any risk factors that contribute to mortality. ⋯ This is the largest single-center series for pediatric patients who require intensive care posthematopoietic stem cell transplant and demonstrates that this group of patients still faces high mortality. There has been an improvement in survival for those patients who require renal replacement therapy and also for patients who require mechanical ventilation more than once; however, the need for mechanical ventilation still remains a significant predictor of mortality.