Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2003
Randomized Controlled Trial Clinical TrialErythropoietin therapy in children with bronchiolitis and anemia.
Critically ill children with bronchiolitis often require red blood cell transfusions. Anemia normally results in increased circulating erythropoietin concentrations; however, critical illness has been associated with a blunted erythropoietin response. Treatment with erythropoietin decreases the need for red blood cell transfusion in several disease states. We hypothesized that critically ill children with bronchiolitis and anemia would have a circulating erythropoietin deficiency and that treatment with exogenous erythropoietin would increase reticulocyte count and hematocrit and reduce red blood cell transfusion requirements. ⋯ Despite a favorable reticulocyte and circulating erythropoietin response, red blood cell transfusion requirements were not significantly diminished by erythropoietin treatment in children with bronchiolitis and respiratory failure. Erythropoietin cannot be routinely recommended for this patient population.
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Pediatr Crit Care Me · Jan 2003
Randomized Controlled Trial Comparative Study Clinical TrialInterpretation of digital radiographs by pediatric critical care physicians using Web-based bedside personal computers versus diagnostic workstations.
To determine whether the interpretations of digital radiographs by pediatric critical care physicians displayed on the bedside personal computer differ from the interpretations of images displayed on the diagnostic workstation. ⋯ With the exception of diffuse chest abnormalities, pediatric critical care physicians can use the Web-based bedside personal computer for clinical decision-making with the confidence that the decisions will be similar to those made on the diagnostic workstation.
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Pediatr Crit Care Me · Jan 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intermittent versus continuous infusion of propofol for elective oncology procedures in children.
To compare the effects of administering propofol as a continuous infusion vs. bolus dosing in children undergoing ambulatory oncologic procedures in the pediatric intensive care unit (PICU). ⋯ Both continuous and bolus administration of propofol provided conditions for conducting oncologic procedures that were satisfying to patients, their families, and physicians. Continuous infusions were associated with a larger total dose and greater decreases in systolic blood pressure. Physician preference is likely to dictate which method is used.
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Pediatr Crit Care Me · Jan 2003
Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis.
To examine the relationships between procalcitonin, bacterial infection, sepsis-induced multiple organ failure, and mortality rate in children. ⋯ Procalcitonin is persistently increased among children with poor outcome from bacterial sepsis. Further study is needed to better delineate this differential procalcitonin response to bacterial vs. nonbacterial sepsis and to characterize any mechanistic role that procalcitonin might play in the development of bacterial sepsis-induced multiple organ failure and mortality.
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Pediatr Crit Care Me · Jan 2003
ReviewThe use of extracorporeal techniques to remove humoral factors in sepsis.
To determine whether there is sufficient evidence of a benefit of hemofiltration or plasma filtration in sepsis. ⋯ There is a lack of randomized trials. The available studies show an absence of benefit for hemofiltration. Further studies are needed in plasma filtration.