Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2019
Early Heart Rate Variability and Electroencephalographic Abnormalities in Acutely Brain-Injured Children Who Progress to Brain Death.
Heart rate variability is controlled by the autonomic nervous system. After brain death, this autonomic control stops, and heart rate variability is significantly decreased. However, it is unknown if early changes in heart rate variability are predictive of progression to brain death. We hypothesized that in brain-injured children, lower heart rate variability is an early indicator of autonomic system failure, and it predicts progression to brain death. We additionally explored the association between heart rate variability and markers of brain dysfunction such as electroencephalogram and neurologic examination between brain-injured children who progressed to brain death and those who survived. ⋯ These results support the concept of autonomic system failure as an early indicator of impending brain death in brain-injured children. Furthermore, decreased heart rate variability is associated with markers of CNS dysfunction such as electroencephalogram abnormalities.
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Pediatr Crit Care Me · Jan 2019
Accuracy of Reported Tidal Volume During Neonatal Ventilation With Airway Leak: A Lung Model Study.
To determine the accuracy of tidal volume reported by neonatal ventilators, with and without leak compensation, in invasive and noninvasive ventilation modes in the presence of airway leak; and, to determine what factors have a significant effect on the accuracy of tidal volume reported by ventilators with leak compensation in the presence of airway leak. We hypothesized that ventilators with a leak compensation function that includes estimation of tidal volume could accurately report tidal volume in the presence of airway leak, but that the accuracy of reported tidal volume may be affected by variables such as the identity of the ventilator, lung mechanics, leak size, positive end-expiratory pressure level, and body size. ⋯ Reported tidal volume is affected by the presence of airway leak, but in many ventilators a leak compensation algorithm that includes estimation of tidal volume can correct for the discrepancy between actual and reported tidal volume. However, even in ventilators with leak compensation, choice of ventilator and lung mechanics in invasive ventilation modes have a significant effect on error of reported tidal volume.
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Pediatr Crit Care Me · Jan 2019
A National Survey on Interhospital Transport of Children in Cardiac Arrest.
To describe the U.S. experience with interhospital transport of children in cardiac arrest undergoing cardiopulmonary resuscitation. ⋯ A minority of U.S. teams perform interhospital transport of children in cardiac arrest undergoing cardiopulmonary resuscitation. Eligibility criteria, transport logistics, and patient outcomes are heterogeneous. Importantly, there is a paucity of established safety protocols for the staff performing cardiopulmonary resuscitation in transport.
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Pediatr Crit Care Me · Jan 2019
The Latin American and Spanish Survey on Nutrition in Pediatric Intensive Care (ELAN-CIP2).
To characterize the practices of nutritional support in Latin American and Spanish PICUs. ⋯ Nutritional practices are heterogeneous in Latin American PICUs, but the majority use nutritional support strategies consistent with international guidelines.
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The objective of this study is to describe the relative frequency of use of continuous renal replacement therapy, intermittent hemodialysis, and peritoneal dialysis and to analyze characteristics and outcomes of critically ill children receiving renal replacement therapies admitted to PICUs that participate in the Virtual PICU (VPS LLC, Los Angeles, CA) registry. ⋯ Continuous renal replacement therapy is an increasingly prevalent renal replacement therapy modality used in critically ill children admitted to an ICU. Higher mortality rate with the use of continuous renal replacement therapy should be interpreted with caution.