Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2017
Identifying Children at Risk of Malignant Bordetella pertussis Infection.
To identify factors associated with malignant pertussis. ⋯ Clinical predictors of malignant pertussis are identifiable within 48 hours of hospital presentation. Early recognition of children at risk of malignant pertussis may facilitate early referral to a PICU for advanced life support and selection for trials of investigational therapies.
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Pediatr Crit Care Me · Jan 2017
Observational StudyClinical Examination Does Not Predict Response to Albuterol in Ventilated Infants With Bronchiolitis.
Bronchiolitis is a common respiratory infection in infants that is sometimes treated with albuterol. Response to albuterol is determined by clinical assessment, but this subjective determination is potentially unreliable. In this study, we compared providers' clinical assessment of response to albuterol with the measurement of response by pulmonary mechanics in intubated, sedated, and ventilated infants. ⋯ A provider's clinical assessment was not a reliable method for determining response to albuterol in children with bronchiolitis. Without assessment of pulmonary mechanics, caution should be used in classifying children with bronchiolitis as responders to albuterol.
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Pediatr Crit Care Me · Jan 2017
Evaluating the Performance of the Pediatric Acute Lung Injury Consensus Conference Definition of Acute Respiratory Distress Syndrome.
The Pediatric Acute Lung Injury Consensus Conference has developed a pediatric-specific definition of acute respiratory distress syndrome, which is a significant departure from both the Berlin and American European Consensus Conference definitions. We sought to test the external validity and potential impact of the Pediatric Acute Lung Injury Consensus Conference definition by comparing the number of cases of acute respiratory distress syndrome and mortality rates among children admitted to a multidisciplinary PICU when classified by Pediatric Acute Lung Injury Consensus Conference, Berlin, and American European Consensus Conference criteria. ⋯ Applying the Pediatric Acute Lung Injury Consensus Conference definition of acute respiratory distress syndrome has the potential to significantly increase the number of acute respiratory distress syndrome patients identified, with a lower overall mortality rate. However, severe acute respiratory distress syndrome is associated with extremely high mortality, particularly if present at 24 hours after initial diagnosis.
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Pediatr Crit Care Me · Jan 2017
An Elevated Low Cardiac Output Syndrome Score Is Associated With Morbidity in Infants After Congenital Heart Surgery.
To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. ⋯ Higher peak Low Cardiac Output Syndrome Score and cumulative Low Cardiac Output Syndrome Score were associated with increased morbidity and resource utilization among infants following surgery for congenital heart defects and might be a useful tools in future cardiac intensive care research. Independent validation is required.