Pediatr Crit Care Me
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To determine whether critically ill children are hypermetabolic and to calculate whether predictive equations are appropriate for critically ill children. ⋯ Children do not become hypermetabolic during critical illness. These data suggest that agreement between resting energy expenditure and the predictive equations are so broad that they are inappropriate for use in critically ill children.
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Pediatr Crit Care Me · Apr 2003
Cephalad movement of endotracheal tubes caused by prone positioning pediatric patients with acute respiratory distress syndrome.
To test the hypothesis that prone positioning of patients with acute respiratory distress syndrome results in significant cephalad movement of their endotracheal tubes (ETT). ⋯ Prone positioning results in cephalad movement of ETT within the trachea. The tip of the ETT should be deeper than one third of the total length of the thoracic trachea before prone positioning to prevent it from moving into the cervical trachea. When prone positioning is done with an ETT originally not deeper than one third of the thoracic trachea, obtaining a chest radiograph immediately after prone positioning is important to determine whether the ETT remained safely situated in the trachea.
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Pediatr Crit Care Me · Apr 2003
Economic costs of care in extremely low birthweight infants during the first 2 years of life.
To assess the 2-yr costs of extremely low birthweight infants' (ELBWIs; birthweight, < 1000 g) care in relation to birthweight, outcome, and the costs of normal birthweight infants. ⋯ Total costs of ELBWIs decreased over time up to the age of 2 yrs, but even in normally developed ELBWIs, costs remained higher than those of normal birthweight infants. Low birthweight seemed to be related to increased initial hospital costs but not to annual costs after the first discharge.
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Pediatr Crit Care Me · Apr 2003
Parental experience of highly technical therapy: survivors and nonsurvivors of extracorporeal membrane oxygenation support.
To describe the experience of parents of critically ill infants and children who require highly technical therapy and to identify interventions that parents might find helpful during the experience. ⋯ Researched-based family-driven care requires an understanding of parental experience and worries, and interventions that parents themselves identify as helpful. Continued sensitive individualized care is warranted.
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Pediatr Crit Care Me · Apr 2003
Case ReportsNear-fatal grape aspiration with complicating acute lung injury successfully treated with extracorporeal membrane oxygenation.
In this report of a near-fatal case of grape aspiration successfully treated with extracorporeal membrane oxygenation (ECMO), we highlight the danger of feeding seedless grapes to young children and demonstrate that ECMO can provide cardiopulmonary support for cases of acquired large-airway disruption and can facilitate therapeutic intervention. ⋯ Aspiration of a seedless grape is a life-threatening event in a small child. This danger is not fully appreciated by parents in the UK. ECMO may be life saving in cases of acquired large-airway disruption resulting in severe cardiopulmonary failure, including foreign body aspiration, as long as end-organ perfusion is maintained.