Pediatr Crit Care Me
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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.
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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.
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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.
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Pediatr Crit Care Me · Jul 2022
School Closures in the United States and Severe Respiratory Illnesses in Children: A Normalized Nationwide Sample.
To determine the association between nationwide school closures and prevalence of common admission diagnoses in the pediatric critical care unit. ⋯ School closures are associated with a dramatic reduction in the prevalence of severe respiratory disease requiring PICU admission. School closure may be an effective tool to mitigate future pandemics but should be balanced with potential academic, economic, mental health, and social consequences.
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Pediatr Crit Care Me · Jul 2022
Risk Factors for Sepsis-Associated Acute Kidney Injury in the PICU: A Retrospective Cohort Study.
Acute kidney injury (AKI), particularly of greater severity and longer duration, is associated with increased morbidity and mortality in the pediatric population. AKI frequently occurs during sepsis, yet the knowledge of risk factors for sepsis-associated AKI in the PICU is limited. We aimed to identify risk factors for AKI that develops or persists after 72 hours from sepsis recognition in pediatric patients with severe sepsis. ⋯ In children with severe sepsis, the degree of hemodynamic support as measured by the VIS and the presence of fluid overload may identify patients at increased risk of developing severe AKI.