Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2022
Multicenter StudyDevelopmental Care Practice and Documentation Variability in the Cardiac ICU.
Describe variability in developmental care practices, as documented in the electronic health record, for infants undergoing congenital heart surgery. ⋯ There are significant, quantifiable variations in documented developmental care practices at both the individual and site level. More reliable documentation of developmental care practices is required to associate these variables with later outcomes and investigate disparities in individualized developmental care practices.
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Pediatr Crit Care Me · Mar 2022
Multicenter StudyHospital Charges Associated With Critical Bronchiolitis From 2009 to 2019.
To evaluate the contribution of PICU care to increasing hospital charges for patients with bronchiolitis over a 10-year study period. ⋯ In a multicenter cohort study of children hospitalized with bronchiolitis, PICU patients, especially low-risk children without the need for IMV, were the highest driver of increased hospital charges over a 10-year study period.
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Pediatr Crit Care Me · Mar 2022
Meta AnalysisBalanced Versus Unbalanced Fluid in Critically Ill Children: Systematic Review and Meta-Analysis.
The ideal crystalloid fluid bolus therapy for fluid resuscitation in children remains unclear, but pediatric data are limited. Administration of 0.9% saline has been associated with hyperchloremic metabolic acidosis and acute kidney injury. The primary objective of this systematic review was to compare the effect of balanced versus unbalanced fluid bolus therapy on the mean change in serum bicarbonate or pH within 24 hours in critically ill children. ⋯ Our systematic review found some evidence of improvement in blood pH and bicarbonate values in critically ill children after 4-12 hours of fluid bolus therapy with balanced fluid compared with the unbalanced fluid. However, a randomized controlled trial is needed to establish whether these findings have an impact on clinical outcomes before recommendations can be generated.
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Pediatr Crit Care Me · Mar 2022
Oral Aversion in Infants With Congenital Heart Disease: A Single-Center Retrospective Cohort Study.
Neonates undergoing cardiac surgery are at risk for oral aversion (OA). OA is not well described outside of the index hospitalization and impacts patients and families. We evaluated the prevalence of OA at 1 year old after neonatal cardiopulmonary bypass (CPB) surgery. ⋯ OA and other feeding difficulties are common at 1 year old in neonates undergoing CPB surgery. Delayed exposure to oral intake may be a modifiable risk factor for OA and efforts to improve early oral feeding could lead to better functional outcomes.