Pediatr Crit Care Me
-
Pediatr Crit Care Me · Jul 2022
Observational StudyPrevalence of Cardiac Dysfunction in Malawian Children With Severe Febrile Illness.
To investigate the prevalence of left ventricular systolic dysfunction (LVSD) in Malawian children with severe febrile illness and to explore associations between LVSD and mortality and lactate levels. ⋯ Cardiac dysfunction may be present in one in four Malawian children with severe febrile illness, and mortality in these patients is especially high. Larger studies are needed to further clarify the role cardiac dysfunction plays in mortality and integrate practical bedside assessments for decision support around individualized resuscitation strategies.
-
Pediatr Crit Care Me · Jul 2022
Observational StudyDevelopment and External Validation of a Machine Learning Model for Prediction of Potential Transfer to the PICU.
Unrecognized clinical deterioration during illness requiring hospitalization is associated with high risk of mortality and long-term morbidity among children. Our objective was to develop and externally validate machine learning algorithms using electronic health records for identifying ICU transfer within 12 hours indicative of a child's condition. ⋯ We developed and externally validated a novel machine learning model that identifies ICU transfers in hospitalized children more accurately than current tools. Our model enables early detection of children at risk for deterioration, thereby creating opportunities for intervention and improvement in outcomes.
-
Pediatr Crit Care Me · Jul 2022
Clinical TrialSuboptimal Beta-Lactam Therapy in Critically Ill Children: Risk Factors and Outcome.
In critically ill children, severely altered pharmacokinetics may result in subtherapeutic β-lactam antibiotic concentrations when standard pediatric dosing regimens are applied. However, it remains unclear how to recognize patients most at risk for suboptimal exposure and their outcome. This study aimed to: 1) describe target attainment for β-lactam antibiotics in critically ill children, 2) identify risk factors for suboptimal exposure, and 3) study the association between target nonattainment and clinical outcome. ⋯ Subtherapeutic β-lactam concentrations are common in critically ill children and correlate with renal function. eGFR equations may be helpful in identifying patients who may require higher dosing. Future studies should focus on the impact of subtherapeutic concentrations on clinical outcome.
-
Pediatr Crit Care Me · Jul 2022
Epidemiology of Pediatric Critical Care Admissions in 43 United States Children's Hospitals, 2014-2019.
To identify trends in the population of patients in PICUs over time. ⋯ The proportional use of PICU beds is increasing over time, although was variable across centers. Case-based resource use and complexity of pediatric patients are also increasing. Despite the higher use of PICU resources, the standardized costs of PICU care per patient encounter have remained stable. These data may help to inform current PICU resource allocation and future PICU capacity planning.
-
Pediatr Crit Care Me · Jul 2022
Inferior and Superior Vena Cava Saturation Monitoring After Neonatal Cardiac Surgery.
Superior vena cava oxygen saturation (SVC O 2 ) monitoring is well described for early detection of hemodynamic deterioration after neonatal cardiac surgery but inferior vena cava vein oxygen saturation (IVC O 2 ) monitoring data are limited. ⋯ In postoperative neonates, admission IVC O 2 and SVC O 2 correlate. Lower admission IVC O 2 may identify a cohort of postsurgical neonates at risk for low cardiac output and associated morbidity.