Pediatr Crit Care Me
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Pediatr Crit Care Me · Dec 2015
Impact of Retrieval, Distance Traveled, and Referral Centre on Outcomes in Unplanned Admissions to a National PICU.
Centralization of PICUs requires a transport system that delivers patient outcomes equivalent to that of the same institution admissions. Our aim was to evaluate how pediatric critical care retrieval, distance traveled, and referral centre level of ICU support impact on outcomes in unplanned admissions. ⋯ Children retrieved to the national PICU in New Zealand have greater predicted mortality risk and PICU-specific resource use than nontransported patients. There is no significant difference in risk-adjusted mortality between retrieved and the same institution admissions. Critically ill pediatric patients can be transported long distances by specially trained and equipped transport teams, without an increase in risk-adjusted PICU mortality.
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Pediatr Crit Care Me · Dec 2015
Dexmedetomidine Is Associated With Lower Incidence of Acute Kidney Injury After Congenital Heart Surgery.
Recent data have suggested an association between the use of dexmedetomidine and a decreased incidence of acute kidney injury in adult patients after cardiopulmonary bypass. However, no study has focused on this association among pediatric populations where the incidence of acute kidney injury is particularly high and of critical significance. The primary objective of this study was to assess the relationship between the use of postoperative dexmedetomidine and the incidence of acute kidney injury in pediatric patients undergoing cardiopulmonary bypass. The secondary objective was to determine whether there was an association between dexmedetomidine use and duration of mechanical ventilation or cardiovascular ICU stay. ⋯ The use of a dexmedetomidine infusion in pediatric patients after congenital heart surgery was associated with a decreased incidence of acute kidney injury; however, it was not associated with changes in clinical outcomes. Further prospective study is necessary to validate these findings.
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Pediatr Crit Care Me · Nov 2015
An Evaluation of Family-Centered Rounds in the PICU: Room for Improvement Suggested by Families and Providers.
To identify areas for improvement in family-centered rounds from both the family and provider perspectives. ⋯ Family presence increased the length of family-centered rounds despite a small percentage of time spoken by families, suggesting longer rounds are due to changes in provider behavior when families are present. Also, non-English-speaking families may need more support to be able to attend and benefit from family-centered rounds. Lastly, in an era of full family-centered rounds acceptance, families and most providers, except fellows, report benefit from family presence during family-centered rounds. However, providers should be aware of the perception of their behaviors to optimize the experience for families.