Pediatr Crit Care Me
-
Pediatr Crit Care Me · Sep 2016
Editorial CommentPlatelet Transfusions in the PICU: Tiny Cells, Big Issue.
-
Pediatr Crit Care Me · Sep 2016
ReviewOptimizing Team Dynamics: An Assessment of Physician Trainees and Advanced Practice Providers Collaborative Practice.
The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. ⋯ Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.
-
Pediatr Crit Care Me · Sep 2016
Comparative Study Clinical TrialCircuit Lifetime With Citrate Versus Heparin in Pediatric Continuous Venovenous Hemodialysis.
To determine if there is a difference between regional citrate and global heparinized anticoagulation on circuit lifetimes during continuous venovenous hemodialysis in children. ⋯ We showed in our study that citrate provided significantly longer circuit lifetimes than heparin for continuous venovenous hemodialysis in children. Citrate was superior to heparin for the transfusion requirements. Citrate was feasible and safe in children and infants.
-
Pediatr Crit Care Me · Sep 2016
Multicenter StudyGlobal Trends in Extracorporeal Membranous Oxygenation Use and Survival of Patients With Influenza-Associated Illness.
To determine the overall use of extracorporeal membranous oxygenation for influenza-associated illness and describe risk factors associated with mortality in these patients. ⋯ Extracorporeal membranous oxygenation use for individuals with influenza increased over time, particularly after the 2009 H1N1 pandemic, most notably among older adults. Survival to hospital discharge for patients with influenza on extracorporeal membranous oxygenation was slightly higher than survival to hospital discharge for respiratory illness due to any cause. Bacterial codetection was common among patients with influenza on extracorporeal membranous oxygenation and was associated with increased days on extracorporeal membranous oxygenation but not increased mortality. Only S. aureus codetection in children was associated with increased in-hospital mortality.
-
Pediatr Crit Care Me · Sep 2016
Admission Plasma Troponin I Is Associated With Mortality in Pediatric Intensive Care.
Assessment of whether admission plasma troponin I level is associated with mortality or requirement for vasoactive drugs in pediatric intensive care. ⋯ Detectable plasma troponin I at admission to PICU is independently associated with death. The utility of troponin I as a stratification biomarker requires further evaluation.