Pediatr Crit Care Me
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Pediatr Crit Care Me · Apr 2017
Glucocorticoid Receptor Polymorphisms and Outcomes in Pediatric Septic Shock.
Polymorphisms of the glucocorticoid receptor gene are associated with outcome and corticosteroid responsiveness among patients with inflammatory disorders. We conducted a candidate gene association study to test the hypothesis that these polymorphisms are associated with outcome and corticosteroid responsiveness among children with septic shock. ⋯ Based on these glucocorticoid receptor polymorphisms, we could not detect a beneficial effect of corticosteroids among any genotype group. Among children homozygous for the wild-type allele, corticosteroids were independently associated with increased odds of poor outcome.
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Pediatr Crit Care Me · Apr 2017
Observational StudyRelationship Between Adverse Tracheal Intubation Associated Events and PICU Outcomes.
Tracheal intubation in PICUs is a common procedure often associated with adverse events. The aim of this study is to evaluate the association between immediate events such as tracheal intubation associated events or desaturation and ICU outcomes: length of stay, duration of mechanical ventilation, and mortality. ⋯ Adverse tracheal intubation associated events and desaturations are common and associated with longer mechanical ventilation in critically ill children. Severe tracheal intubation associated events are associated with higher ICU mortality. Potential interventions to decrease tracheal intubation associated events and oxygen desaturation, such as tracheal intubation checklist, use of apneic oxygenation, and video laryngoscopy, may need to be considered to improve ICU outcomes.
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Pediatr Crit Care Me · Apr 2017
Observational StudyEffect of Temperature on Heart Rate Variability in Neonatal ICU Patients With Hypoxic-Ischemic Encephalopathy.
To determine whether measures of heart rate variability are related to changes in temperature during rewarming after therapeutic hypothermia for hypoxic-ischemic encephalopathy. ⋯ Measures of heart rate variability are temperature dependent in the range of therapeutic hypothermia to normothermia. Core body temperature needs to be considered when evaluating heart rate variability metrics as potential physiologic biomarkers of illness severity in hypoxic-ischemic encephalopathy infants undergoing therapeutic hypothermia.
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Pediatr Crit Care Me · Apr 2017
Factors Associated With Mortality in Low-Risk Pediatric Critical Care Patients in The Netherlands.
To determine differences between survivors and nonsurvivors and factors associated with mortality in pediatric intensive care patients with low risk of mortality. ⋯ Nonsurvivors in the PICU with a low predicted mortality risk have recognizable risk factors including complex chronic condition and unplanned admissions.
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Pediatr Crit Care Me · Apr 2017
Career Development Support in Pediatric Critical Care Medicine: A National Survey of Fellows and Junior Faculty.
To determine the perceptions of current pediatric critical care medicine fellows and junior faculty regarding the extent and quality of career development support received during fellowship training. ⋯ Most pediatric critical care medicine fellows and junior faculty reported good to excellent career development support during fellowship. However, important gaps remain, particularly for those pursuing community-based (nonacademic) and administrative tracks. Fellows were uncertain regarding future pediatric critical care medicine employment and their ability to pursue ideal career tracks. There may be a role for professional organizations to provide additional resources for career development in pediatric critical care medicine.