Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2021
Observational StudyCompliance With an Antibiotic Guideline for Suspected Ventilator-Associated Infection: The Ventilator-Associated INfection (VAIN2) Study.
To evaluate a guideline for antibiotic decisions in children with suspected ventilator-associated infection. ⋯ Antibiotic guideline efficacy and safety remain uncertain due to clinician failure to follow the guideline, instead primarily relying on respiratory culture results. Strategies to overcome clinician perceptions of respiratory cultures and other barriers will be vital for improving guideline adherence and antibiotic use in suspected ventilator-associated infection in future studies.
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Pediatr Crit Care Me · Oct 2021
Implementation of an Analgesia-Sedation Protocol Is Associated With Reduction in Midazolam Usage in the PICU.
Examine the association of a revised analgesia-sedation protocol with midazolam usage in the PICU. ⋯ We successfully implemented an analgesia-sedation protocol that primarily uses dexmedetomidine and intermittent opioids, and it was associated with significant decrease in overall midazolam usage in mechanically ventilated patients in the PICU. The intervention was not associated with changes in opioid usage or prevalence of adverse events.
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Pediatr Crit Care Me · Oct 2021
Observational StudyA Cross-Sectional Study of the Clinical Metrics of Functional Status Tools in Pediatric Critical Illness.
To determine the clinical metrics of functional assessments in pediatric critical illness survivors. ⋯ PICU functional assessment tools have varying clinical metrics. Considering ceiling effects, Pediatric Evaluation of Disability Inventory-Computer Adaptive Test may be more suitable in survivors than Functional Status Scale. Differences in scores between children with or without complex chronic conditions, and with or without baseline functional impairment, were not observed. Functional assessments likely require a combination of tools to measure the spectrum of pediatric critical illness and recovery.
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Pediatr Crit Care Me · Oct 2021
eSIMPLER: A Dynamic, Electronic Health Record-Integrated Checklist for Clinical Decision Support During PICU Daily Rounds.
Design, implement, and evaluate a rounding checklist with deeply embedded, dynamic electronic health record integration. ⋯ eSIMPLER, a dynamic, electronic health record-informed checklist, required less time to complete and improved certain care processes compared with a prior, static checklist with limited electronic health record data. By focusing on the "Five Rights" of clinical decision support, we created a well-accepted clinical decision support tool that was integrated efficiently into daily rounds. Generalizability of eSIMPLER's effectiveness and its impact on patient outcomes need to be examined.
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Pediatr Crit Care Me · Oct 2021
Observational StudyUltrasound Assessment of Quadriceps Femoris Muscle Thickness in Critically Ill Children.
Evaluate the reliability of ultrasound to measure quadriceps femoris muscle thickness in critically ill children and to describe serial changes in quadriceps femoris muscle thickness in relation to fluid balance and nutritional intake. ⋯ Averaged ultrasound measurements of quadriceps femoris muscle thickness demonstrate good to excellent reliability, are not confounded by fluid balance, and are useful for tracking changes in muscle thickness that are associated with nutritional intake. Ultrasound-based assessment of quadriceps femoris is a clinically useful tool for evaluating muscle mass and may be a proxy for nutritional status.