Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2021
Transfusion Practices in Pediatric Cardiac Surgery Requiring Cardiopulmonary Bypass: A Secondary Analysis of a Clinical Database.
To describe blood component usage in transfused children with congenital heart disease undergoing cardiopulmonary bypass surgery across perioperative settings and diagnostic categories. ⋯ Children with congenital heart disease undergoing cardiopulmonary bypass surgery are transfused many blood components both intraoperatively and postoperatively. Multiple blood components are transfused intraoperatively at seemingly normal/low-normal pretransfusion values. Pediatric evidence guiding blood component transfusion in this population at high risk of bleeding and with limited physiologic reserve is needed to advance safe and effective blood conservation practices.
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Pediatr Crit Care Me · Nov 2021
Observational StudyFibrinolytic Impairment and Mortality in Pediatric Septic Shock: A Single-Center Prospective Observational Study.
Fibrinolytic shutdown is associated with poor prognosis in adult sepsis, but data in the pediatric population are sparse. This study aimed to identify the association between impaired fibrinolysis and mortality in pediatric septic shock. ⋯ Fibrinolytic shutdown in pediatric septic shock is associated with an increase in disease severity and mortality. This highlights the need for further investigations regarding whether fibrinolytic therapy improved the outcome of pediatric septic shock.
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Pediatr Crit Care Me · Nov 2021
Prolonged Mechanical Ventilation in Children: Review of the Definition.
To review existing definitions of prolonged mechanical ventilation in children. ⋯ There is limited evidence to determine the definition of prolonged mechanical ventilation in children. The variety of definitions is a sign of the need for a consensus definition of pediatric prolonged mechanical ventilation.
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Pediatr Crit Care Me · Nov 2021
Outcomes of Children With Firearm Injuries Admitted to the PICU in the United States.
Firearm-related injury is the second leading cause of injury and death for children 1-18 years old in United States. The objective of our study was to analyze the outcomes of children admitted to the PICU with firearm injuries. ⋯ Mortality rate of children with firearm injury admitted to the PICU is high. Children admitted to the PICU with suicide attempt with a firearm carried the highest mortality. Further studies may help further define the epidemiology of firearm injuries in children and plan interventions to minimize these unnecessary deaths.
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Pediatr Crit Care Me · Nov 2021
Geographic Distance to Extracorporeal Life Support Centers for Pediatric Patients Within the Continental United States.
Distance to subspecialty surgical care is a known impediment to the delivery of high-quality healthcare. Extracorporeal life support is of benefit to pediatric patients with specific medical conditions. Despite a continued increase in the number of extracorporeal life support centers, not all children have equal access to extracorporeal life support due to geographic constraints, creating a potential disparity in healthcare. We attempted to better define the variation in geographic proximity to extracorporeal life support centers for pediatric patients using the U.S. Decennial Census. ⋯ Disparities in proximity to extracorporeal life support centers were present and persistent across states. Children in rural areas have less access to extracorporeal life support centers based upon geographic distance alone. These findings may affect practice patterns and treatment decisions and are important to the development of regionalization strategies to ensure all children have subspecialty surgical care available to them, including extracorporeal life support.