Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2020
Design and Rationale for Common Data Elements for Clinical Research in Pediatric Critical Care Medicine.
Common data elements are a combination of a precisely defined question paired with a specified set of responses. Common data elements contribute to the National Institutes of Health-supported principle of Findable, Accessible, Interoperable, and Reusableness of research data. Routine use of Common data elements and standardized definitions within pediatric critical care research are likely to promote collaboration, improve quality, and consistency of data collection, improve overall efficiency of study or trial setup, and facilitate cross-study comparisons, meta-analysis, and merging of study cohorts. The purpose of this Pediatric Critical Care Medicine Perspective is to establish a road map for the development of multinational, multidisciplinary consensus-based common data elements that could be adapted for use within any pediatric critical care subject area. ⋯ We describe a multistep process for the creation of "core domains" of research (e.g. patient outcomes, health-related conditions, or aspects of health) and the development of common data elements within each core domain. We define a tiered approach to data collection based on relevance of each common data element to future studies and clinical practice within the field of interest. Additionally, we describe the use of the Delphi methods to achieve consensus of these common data element documents using an international, multidisciplinary panel of experts.
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Pediatr Crit Care Me · Nov 2020
eStablish And Formalize Expert Criteria for Avoidable Resuscitation Review (SAFECARR) Electronic Delphi: Development of a Consensus Framework for Classifying and Reviewing Cardiac Arrests Within the PICU.
To develop a consensus framework that can guide the process of classifying and reviewing pediatric in-hospital cardiac arrest in the PICU. ⋯ A multidisciplinary group of pediatric resuscitation experts generated a consensus-based framework to classify and review pediatric in-hospital cardiac arrest in the PICU. Future work will focus on the application of this framework and further validation of these definitions and contributing factors for in-hospital cardiac arrest both within and outside the PICU.
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Pediatr Crit Care Me · Nov 2020
Prevalence of Seizures and Risk Factors for Mortality in a Continuous Cohort of Pediatric Extracorporeal Membrane Oxygenation Patients.
To evaluate the risk factors for mortality in pediatric extracorporeal membrane oxygenation patients. ⋯ Seizures are common in children requiring extracorporeal membrane oxygenation support, with a high rate of electrographic seizures and status epilepticus, as in prior studies. Presence of cerebral edema is both risk factor for mortality and seizures. Other risk factors for mortality include extracorporeal cardiopulmonary resuscitation, high lactate levels, and prolonged deep hypothermic circulatory arrest.
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Pediatr Crit Care Me · Nov 2020
Unplanned PICU Readmission in a Middle-Income Country: Who Is at Risk and What Is the Outcome?
To study the rate of unplanned PICU readmission, determine the risk factors and its impact on mortality. ⋯ Despite the lack of resources and expertise in lower- and middle-income countries, the rate and factors for PICU readmission are similar to those in high-income countries. However, PICU readmission has no statistically significant association with mortality.
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The objective of this study is to determine outcomes of recurrent cardiac arrest events in the general pediatric inpatient population. ⋯ Survival after pediatric in-hospital recurrent cardiac arrest is higher than previously reported. There is also evidence that initial rhythm other than ventricular tachycardia/ventricular fibrillation and longer duration of cardiopulmonary resuscitation as well as multiple organ dysfunction and more severe lactic acidosis in the peri-arrest period are associated with poor outcomes.