Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2016
Review Practice GuidelinePediatric Cardiac Intensive Care Society 2014 Consensus Statement: Pharmacotherapies in Cardiac Critical Care Antiarrhythmics.
Arrhythmias are a common occurrence in critically ill pediatric patients. Pharmacotherapy is a usual modality for treatment and prevention of arrhythmias in this patient population. This review will highlight particular arrhythmias in the pediatric critical care population and discuss salient points of pharmacotherapy of these arrhythmias. The mechanisms of action for the various agents, potential adverse events, place in therapy, and evidence for their use will be summarized. ⋯ Specialized knowledge as to the safe and effective use of the antiarrhythmic pharmacotherapy in the intensive care setting can lead to safe and effective rhythm management in patients with complex heart disease.
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Pediatr Crit Care Me · Mar 2016
Review Practice GuidelinePediatric Cardiac Intensive Care Society 2014 Consensus Statement: Pharmacotherapies in Cardiac Critical Care: Sedation, Analgesia and Muscle Relaxant.
This article reviews pharmacotherapies currently available to manage sedation, analgesia, and neuromuscular blockade for pediatric cardiac critical patients. ⋯ In the cardiac ICU, management of the cardiac patient requires an individualized sedative and analgesic strategy that maintains hemodynamic stability. Multiple pharmacological therapies exist to achieve these goals and should be selected based on the patient's underlying physiology, hemodynamic vulnerabilities, desired level of sedation and analgesia, and the projected short- or long-term recovery trajectory.
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Pediatr Crit Care Me · Mar 2016
ReviewPediatric Donation After Circulatory Determination of Death: A Scoping Review.
Although pediatric donation after circulatory determination of death is increasing in frequency, there are no national or international donation after circulatory determination of death guidelines specific to pediatrics. This scoping review was performed to map the pediatric donation after circulatory determination of death literature, identify pediatric donation after circulatory determination of death knowledge gaps, and inform the development of national or regional pediatric donation after circulatory determination of death guidelines. ⋯ This review provides a comprehensive overview of the published literature related to pediatric donation after circulatory determination of death. In addition to informing the development of pediatric-specific guidelines, this review serves to highlight several important knowledge gaps in this topic.
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Pediatr Crit Care Me · Mar 2016
Strategies to Maximize Enrollment in a Prospective Study of Comatose Children in the PICU.
To analyze barriers to recruitment encountered during a prospective study in the PICU and evaluate strategies implemented to improve recruitment. ⋯ Identifying barriers to recruitment and implementing creative strategies to increase recruitment can successfully increase enrollment rates in the challenging ICU environment.
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Pediatr Crit Care Me · Mar 2016
Reduction of Broad-Spectrum Antimicrobial Use in a Tertiary Children's Hospital Post Antimicrobial Stewardship Program Guideline Implementation.
The core strategies recommended for antimicrobial stewardship programs, formulary restriction with preauthorization and prospective audit and feedback, can be difficult to implement with limited resources; therefore, we took an approach of guideline development and education with the goal of reducing overall antibiotic use and unwarranted use of broad-spectrum antimicrobials. ⋯ Guideline implementation was successful in reducing targeted broad-spectrum antibiotic use and acquisition cost. Programs with very limited resources may find similar implementation of guidelines effective to provide initial success, so that putting into practice one of the more resource intensive core strategies, such as prospective audit and feedback, may be feasible.