Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2019
Randomized Controlled Trial Multicenter StudyCardiac Arrest Outcomes in Children With Preexisting Neurobehavioral Impairment.
To describe survival and 3-month and 12-month neurobehavioral outcomes in children with preexisting neurobehavioral impairment enrolled in one of two parallel randomized clinical trials of targeted temperature management. ⋯ This study demonstrates the feasibility, utility, and challenge of including this population in clinical neuroprotection trials. In children with preexisting neurobehavioral impairment, one-third survived to 12 months and their neurobehavioral outcomes varied broadly.
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Pediatr Crit Care Me · Jun 2019
Randomized Controlled TrialEarly Protocolized Versus Usual Care Rehabilitation for Pediatric Neurocritical Care Patients: A Randomized Controlled Trial.
s: Few feasibility, safety, and efficacy data exist regarding ICU-based rehabilitative services for children. We hypothesized that early protocolized assessment and therapy would be feasible and safe versus usual care in pediatric neurocritical care patients. ⋯ A protocol for early personalized rehabilitation by physical therapy, occupational therapy, and speech and language therapy in pediatric neurocritical care patients could be safely implemented and led to more ICU-based treatment sessions, accelerating the temporal profile and changing composition of interventions versus usual care, but not altering the total dose of rehabilitation.
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Pediatr Crit Care Me · Jun 2019
Multicenter Study Observational StudyAdverse Tracheal Intubation-Associated Events in Pediatric Patients at Nonspecialist Centers: A Multicenter Prospective Observational Study.
In tertiary care PICUs, adverse tracheal intubation-associated events occur frequently (20%; severe tracheal intubation-associated events in 3-6.5%). However, pediatric patients often present to nonspecialist centers and require intubation by local teams. The rate of tracheal intubation-associated events is not well studied in this setting. We hypothesized that the rate of tracheal intubation-associated events would be higher in nonspecialist centers. ⋯ Tracheal intubation-associated events are common in critically ill pediatric patients who present to nonspecialist centers. The rate of severe tracheal intubation-associated events is much higher in these centers as compared with the PICU setting. There should be a greater focus on improving the safety of intubations occurring in nonspecialist centers.
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Pediatr Crit Care Me · Jun 2019
Multicenter StudyIs Whole-Body CT Associated With Reduced In-Hospital Mortality in Children With Trauma? A Nationwide Study.
We aimed to investigate whether whole-body CT for children with trauma is associated with a different mortality than only selective CT. ⋯ In this nationwide study, whole-body CT was frequently used among Japanese children with trauma. However, compared with the use of selective CT, our results did not support the use of whole-body CT to reduce in-hospital mortality. Selective use of imaging may result in less radiation exposure and provide more benefits than whole-body CT to pediatric trauma patients.