Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2015
Risk Factors for Extubation Failure Following Neonatal Cardiac Surgery.
Extubation failure after neonatal cardiac surgery has been associated with considerable postoperative morbidity, although data identifying risk factors for its occurrence are sparse. We aimed to determine risk factors for extubation failure in our neonatal cardiac surgical population. ⋯ Neonates with underlying genetic abnormalities, hypoplastic left heart, or postoperative infection were at increased risk for extubation failure. A more conservative approach in these patients, including longer pre-extubation duration of antibiotic therapy for postoperative infections, may be warranted.
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Pediatr Crit Care Me · Nov 2015
ReviewGastric Dysmotility in Critically Ill Children: Pathophysiology, Diagnosis, and Management.
We aimed to review gastric dysmotility in critically ill children: 1) its pathophysiology, with a focus on critical care diseases and therapies that affect gastric motility, 2) diagnostic methodologies, and 3) current and future potential therapies. ⋯ Gastric dysmotility is common in critically ill children and impacts patient safety and outcomes. However, it is poorly understood, inadequately defined, and current therapies are limited and based on scant evidence. Understanding gastric motility and developing accurate bedside measures and novel therapies for gastric emptying are highly desirable and need to be further investigated.
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Pediatr Crit Care Me · Nov 2015
Randomized Controlled Trial Multicenter StudyTargeting Glycemic Control After Pediatric Cardiac Surgery: The Influence of Age on Insulin Requirement.
Factors influencing the development of hyperglycemia and pattern of insulin requirement in children undergoing cardiac surgery are poorly understood. This study investigated the impact of age on the pattern of hyperglycemia and insulin requirement in children after cardiac surgery. ⋯ When tight glycemic control is targeted in children who have undergone cardiac surgery, children in the older child age group (5-16 yr) require insulin at significantly higher doses. Further study is needed to understand the mechanisms involved.