Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2022
Derivation and Validation of the Critical Bronchiolitis Score for the PICU.
To derive and internally validate a bronchiolitis-specific illness severity score (the Critical Bronchiolitis Score) that out-performs mortality-based illness severity scores (e.g., Pediatric Risk of Mortality) in measuring expected duration of respiratory support and PICU length of stay for critically ill children with bronchiolitis. ⋯ The Critical Bronchiolitis Score performed better than PICU mortality-based scores in measuring expected duration of ICU-level respiratory support and ICU length of stay. This score may have utility to enrich interventional trials and adjust for illness severity in observational studies in this very common PICU condition.
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Pediatr Crit Care Me · Jan 2022
Establishing Entrustable Professional Activities in Pediatric Cardiac Critical Care.
Define a set of entrustable professional activities for pediatric cardiac critical care that are recognized as the core activities of the subspecialty by a diverse group of pediatric cardiac critical care physicians and that can be broadly and consistently applied irrespective of training pathway. ⋯ We generated a set of nine entrustable professional activities, which we believe can be broadly applied to any physician training in pediatric cardiac critical care, irrespective of individual training pathway. Next steps include incorporation of these entrustable professional activities into curriculum design and trainee assessment tools.
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Pediatr Crit Care Me · Jan 2022
Observational StudyCharacteristics and Physiologic Changes After 4% Albumin Fluid Boluses in a PICU.
To describe the characteristics, hemodynamic, and physiologic changes after 4% albumin fluid boluses in critically ill children. ⋯ Fluid boluses of 4% albumin were common and predominantly in children with cardiac disease and sepsis with a median dose of 10 mL/kg given over half an hour. Such treatment was associated with significant hemodynamic changes only in children less than 12 months old, and we failed to identify an association with urine output.
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Pediatr Crit Care Me · Jan 2022
Executive Summary of Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB).
Critically ill children frequently receive plasma and platelet transfusions. We sought to determine evidence-based recommendations, and when evidence was insufficient, we developed expert-based consensus statements about decision-making for plasma and platelet transfusions in critically ill pediatric patients. ⋯ The TAXI-CAB program provides expert-based consensus for pediatric intensivists for the administration of plasma and/or platelet transfusions in critically ill pediatric patients. There is a pressing need for primary research to provide more evidence to guide practitioners.
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Pediatr Crit Care Me · Jan 2022
The Use of Extracorporeal Life Support in Children With Immune-Mediated Diseases.
To describe the use and outcomes of extracorporeal membrane oxygenation support among children with immune-mediated conditions. ⋯ Children with immune-mediated conditions can be successfully supported with extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation use has increased over time, and survival varies considerably by diagnosis.