Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2019
Observational StudyPrediction of Mortality in Newborn Infants With Severe Congenital Diaphragmatic Hernia Using the Chest Radiographic Thoracic Area.
To evaluate whether the preoperative chest radiographic thoracic area in newborn infants with congenital diaphragmatic hernia was related to the length of mechanical ventilation and the total length of stay and whether chest radiographic thoracic area predicted survival to discharge from neonatal care. ⋯ The chest radiograph in infants with severe congenital diaphragmatic hernia can predict survival from neonatal care with high sensitivity and moderate specificity.
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Pediatr Crit Care Me · Jun 2019
An Innovative Virtual Reality Experience in the PICU: A Pilot Study.
Patients in the PICU frequently have limitations that impede independent interactions with their environment. Virtual reality is an immersive experience that may improve outcomes in critically ill children. The objective of this study was to assess feasibility and satisfaction with virtual reality. ⋯ Virtual reality is an innovative, easily administered, and enjoyable tool that subjectively calms PICU patients in an otherwise chaotic environment.
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Pediatr Crit Care Me · Jun 2019
Does an Antimicrobial Time-Out Impact the Duration of Therapy of Antimicrobials in the PICU?
Our aim was to perform an antimicrobial time-out 48-72 hours after commencing therapy in order to achieve a decrease in days of therapy per 1,000 patient days for vancomycin, meropenem, and piperacillin/tazobactam in all PICU patients during an 8-month period. ⋯ A 48-72-hour time-out process in rounds is associated with a reduction in days of therapy for antibiotics commonly used in the PICU and may lead to more appropriate usage. The time-outs are associated with discontinuation, deescalation, or duration being defined, which are key elements of Centers for Disease Control and Prevention-recommended antimicrobial stewardship programs.
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Pediatr Crit Care Me · Jun 2019
Informed Consent for Bedside Procedures in Pediatric and Neonatal ICUs: A Nationwide Survey.
Primary objectives were to discover current practices of informed consent for bedside procedures in the PICU and neonatal ICU and how trainees learn to obtain consent. We also attempted to gauge if program directors felt that one method of consent was subjectively superior to another in the way it fulfilled established ethical criteria for informed consent. ⋯ Most respondents' ICUs use separate procedure-specific written consents for common bedside procedures, although considerable variability exists. Trainees reportedly most often obtain informed consent for procedures. Although most fellowship directors report their program as strong in preparing trainees to obtain consent, this study reveals areas warranting improvement.
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Pediatr Crit Care Me · Jun 2019
Observational StudyIntensivists Performed Percutaneous Bicaval Double-Lumen Echo-Guided Extracorporeal Membrane Oxygenation Cannulation at Bedside in Newborns and Children: A Retrospective Analysis.
To describe a single institution experience on echo-guided percutaneous bicaval double lumen extracorporeal membrane oxygenation cannulation performed at the bedside by intensivists. ⋯ The described technique proved to be feasible, safe, and effective. Further investigation is needed.