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
Case ReportsAcute subdural hematoma after caesarean section: a case report.
The objective of this article is to describe a case of acute subdural hematoma in an infant after difficult delivery and to describe the literature regarding therapy and outcomes of these patients. ⋯ Acute subdural hematoma is a rare but severe intracranial complication of obstetric trauma. The early recognition of this complication and immediate surgical intervention could possibly prevent later neurologic sequelae.
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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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Delineation of multiple organ dysfunction syndrome (MODS) is important because of its frequent occurrence in the pediatric intensive care unit and its association with high mortality. However, studies in children are scarce, all have been done in developed countries, and, unlike adult studies, some showed that sepsis is not related to mortality. The aim of this study was to learn about the epidemiology of MODS in our pediatric intensive care unit and to observe if sepsis is associated with mortality. ⋯ MODS in children usually occurs early, and sepsis increases mortality. Hepatic and gastrointestinal failures are infrequent, and as has been suggested, they could be excluded from the majority of MODS diagnoses.