Pediatr Crit Care Me
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Measuring outcome in pediatric intensive care is necessary to equate the high cost of treatment with benefits to the patient. Although mortality rates and morbidity are relatively insensitive measures of the benefits of treatment, quality of life measurement gives insight into the long-term outcomes. The aim of this study was to investigate the long-term quality of life outcome of children admitted to a pediatric intensive care unit. ⋯ Our results indicate that the long-term outcome in terms of quality of life after admission to a pediatric intensive care unit is good or normal for the majority of surviving children. Those children with a poor outcome are likely to have significant comorbidities or a diagnosis of malignancy.
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Pediatr Crit Care Me · Jan 2002
Detection of pepsin and glucose in tracheal secretions as indicators of aspiration in mechanically ventilated children.
The detection of glucose in tracheal secretions has been used as an indicator of aspiration in mechanically ventilated, tube-fed children. Pepsin detection may be a more specific indicator. We determined the frequency of pepsin and glucose detection in tracheal secretions of mechanically ventilated children and studied the relationships between tracheal secretion pepsin and glucose and clinical evidence of gastroesophageal reflux. ⋯ Pepsin is detectable in tracheal secretions of mechanically ventilated children at risk for aspiration. Elevated glucose concentrations in tracheal secretions can occur by mechanisms other than aspiration of glucose-rich formula. Pepsin may be a more specific marker for aspiration than glucose.
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Pediatr Crit Care Me · Jan 2002
Assessing sedation in the pediatric intensive care unit by using BIS and the COMFORT scale.
To evaluate bispectral index technology in critically ill children and compare its performance to standard clinical assessment of sedation level. ⋯ BIS measurements evaluated in clinically relevant ranges compare favorably with a standard assessment of the level of sedation. However, comparisons of BIS and COMFORT scale measurements at isolated moments during a prolonged pediatric intensive care unit course of sedation were less correlated. BIS may be best used to identify and prevent oversedation of patients in the pediatric intensive care unit.
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Pediatr Crit Care Me · Jan 2002
Treatment and toxicokinetics of acute pediatric arsenic ingestion: danger of arsenic insecticides in children.
To describe the toxicokinetics and management of acute pediatric arsenic ingestion. ⋯ Recovery from arsenic poisoning was attributable to the restoration and maintenance of adequate cardiac output and renal perfusion in early shock, which allowed depot intramuscular British anti-Lewisite to circulate and eliminate the poison. Although an intravenous antiarsenical chelating agent would be advantageous in treating shock from arsenic poisoning, none is currently available. We urge the immediate use of British anti-Lewisite therapy on patient presentation with suspected toxic arsenic ingestion.
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Pediatr Crit Care Me · Oct 2001
Parental coping and bereavement outcome after the death of a child in the pediatric intensive care unit.
Parental grief after the death of a child may be influenced by the chronicity of the child's illness, the quality of care provided, and the parents' ability to cope. Our objective is to identify aspects of pediatric intensive care and parental coping that have a favorable effect on parental bereavement outcome. ⋯ Parents' physical well-being enables more effective handling of early grief. Parents' understanding of their own self-worth and their child's illness determine long-term adaptation to loss. A caring emotional attitude displayed by pediatric intensive care unit staff has beneficial short-term and long-term effects on parental bereavement.